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NLM database Documents
Record 1 from database: MEDLINE
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- Title
- Extended radical operations on breast cancer of medial or central
location.
- Author
- Deemarski LYu; Seleznev IK
- Address
-
- Source
- Surgery, 1984 Jul, 96:1, 73-7
- Abstract
- Two groups of patients with central or medical primary breast
cancer (T1-2N0-1M0) were studied. One group of 478 patients had an
extended radical mastectomy (Urban-Kholdin) that included removal of
the parasternal lymph nodes and adjoining costal cartilages. A
second group of 519 concurrently treated patients had a conventional
radical mastectomy (Halsted-Meyer). Among the patients who had an
extended radical mastectomy, metastases were found in parasternal
lymph nodes in 17.7% of those who had no metastasis in axillary or
subclavicular lymph nodes, 40.9% of those who had a single
metastatic focus in axillary or subclavicular lymph nodes, and 54.2%
of those who had multiple axillary and/or subclavicular nodal
metastases. Comparison of the two groups for the interval to tumor
recurrence showed that extended radical mastectomy provided a better
disease-free survivorship at both 5 and 10 years. Among patients who
had an extended radical mastectomy, results at 5 years were better
by 10.1% for those who had no lymph node metastases at all, better
by 15.6% for those who had a single axillary or subclavicular
metastasis, and better by 16.6% when multiple axillary and/or
subclavicular nodal metastases were present. Follow-up at 10 and 20
years also showed a margin favoring extended radical mastectomy.
Among the patients who had metastases only in parasternal lymph
nodes, the disease-free survival rate was 67.4% at 5 years and 46.2%
at 10 years. Extended radical mastectomy should be considered the
preferred operative procedure for patients 60 years of age or
younger who have primary breast cancer (T1-2N0-1M0) of central or
medial origin.
- Language of Publication
- English
- Unique Identifier
- 84250647
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- MeSH Heading (Major)
- Breast Neoplasms|MO/PA/*SU; Lymph Node Excision|*; Mastectomy|MO/*MT
- MeSH Heading
- Axilla; Female; Human; Lymphatic Metastasis; Middle Age; Sternum
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0039-6060
- Country of Publication
- UNITED STATES
Record 2 from database: MEDLINE
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- Title
- Prognostic indicators in patients with isolated local-regional
recurrence of breast cancer.
- Author
- Bedwinek JM; Lee J; Fineberg B; Ocwieza M
- Address
-
- Source
- Cancer, 1981 May, 47:9, 2232-5
- Abstract
- A retrospective review was undertaken of 129 patients with
isolated local-regional recurrence of breast cancer following
radical or modified radical mastectomy. The overall survival and
disease-free survival for these patients five years from the time of
local-regional recurrence was 36 and 13%, respectively. The clinical
stage at initial diagnosis, the number of histologically positive
nodes at mastectomy, menopausal status, and the location of the
recurrence (chest wall vs. nodal) were all found to have no
significant effect on survival or disease-free survival. On the
other hand, the number of recurrences, the size of the largest
recurrence, and the time interval between mastectomy and recurrence
(disease-free interval) had definite prognostic significance. A
single recurrence, the size of the largest recurrence being less
than or equal to 1 cm, and a disease-free interval of longer than 24
months predicted a good prognosis; on the other hand, multiple
recurrences, the size of the largest recurrence being greater than 1
cm, and a disease-free interval of less than 24 months predicted a
bad prognosis. Eighty-one percent of the patients ultimately
developed distant metastases; the incidence of distant metastases
was the same for patients with factors predicting a good prognosis
as it was for those with factors predicting a bad prognosis. The
time to appearance of distant metastases, however, was significantly
longer in the former group of patients than in the latter. The
information from this analysis should be useful in designing future
clinical trials involving patients with isolated local-regional
recurrence of breast cancer.
- Language of Publication
- English
- Unique Identifier
- 81186065
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- MeSH Heading (Major)
- Breast Neoplasms|PA/*SU; Mastectomy|*; Neoplasm Recurrence,
Local|*
- MeSH Heading
- Female; Human; Neoplasm Metastasis; Prognosis; Retrospective
Studies; Time Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 3 from database: MEDLINE
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- Title
- Cancer and free radicals.
- Author
- Pryor WA
- Address
-
- Source
- Basic Life Sci, 1986, 39:, 45-59
- Abstract
- It is now clear that free radical intermediates often are involved
in the activation of many types of procarcinogens and promutagens to
their active forms as well as in the binding of these activated
species to DNA. In this chapter, a general introduction to free
radical chemistry is presented, with some discussion of radical
lifetimes and reactivities. Potential biological targets of radical
attack include lipids, proteins, and nucleic acids, and the
reactions of all three of these target molecules with radicals are
discussed. Finally, the evidence linking free radical reactions with
chemical carcinogenesis is reviewed. A mechanistic scheme that
divides the mechanisms for activating procarcinogens into 5 types is
suggested; of these, 3 types of mechanisms involve free radicals,
either in the activation of the carcinogen or in its binding to DNA
or both. It also is suggested that a "reverse binding" can
occur in which radicals produced on the DNA backbone attack and bond
to unactivated substrates, rather than activated substrates (such as
radicals) attacking unactivated DNA. It is known that systems that
produce superoxide can lead to the production of hydroxyl radicals
and that these HO. radicals form radical sites on DNA; thus, reverse
binding could occur when any species that can add to a free radical
is in the vicinity of the radical-damaged DNA.
- Language of Publication
- English
- Unique Identifier
- 87025550
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- MeSH Heading (Major)
- Carcinogens|*; Free Radicals|*; Neoplasms|*ET
- MeSH Heading
- Animal; DNA|GE; DNA Damage; Human; Kinetics; Lipid Peroxides|ME;
Proteins|ME; Smoking; Support, Non-U.S. Gov't; Support, U.S. Gov't,
P.H.S.; Tetradecanoylphorbol Acetate|TO
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0090-5542
- Country of Publication
- UNITED STATES
Record 4 from database: MEDLINE
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- Title
- Treatment of early cancer of the breast (T1N0M0 and T2N0M0) on the
basis of histologic characteristics.
- Author
- Nealon TF Jr; Nkongho A; Grossi CE; Ward R; Nealon C; Gillooley JF
- Address
-
- Source
- Surgery, 1981 Mar, 89:3, 279-89
- Abstract
- This is a retrospective study of the results of various types of
surgical treatment of early breast cancer staged histologically
using the following characteristics: (1) poor cytologic
differentiation, (2) lymphatic permeation, (3) blood vessel
invasion, or (4) invasion of the tumor into the surrounding soft
tissue. Four hundred and three patients who had early tumors of the
breast--228 T1N0M0 (tumor 2 cm or less in diameter, no nodal
involvement, and no metastasis) and 175 T2N0M0 (tumor 2 to 5 cm in
diameter, no nodal involvement, and no metastasis)--were treated at
St. Vincent's Hospital and Medical Center between January 1, 1965,
and December 31 1976. Eighty-three were classified as being at low
risk 190 at intermediate risk, and 130 at high risk. At 10 years,
100% of the low-risk group were alive; 99% were free of disease, and
any type of mastectomy performed--radical, modified radical, or
total--was adequate. At 10 years, 44% of those at high risk were
alive, and 30% were free of disease. Radiotherapy improved life
expectancy when added to radical mastectomy in the high-risk group.
We recommend a prior excisional biopsy for proper histologic
evaluation to allow a more appropriate choice of surgical procedure.
- Language of Publication
- English
- Unique Identifier
- 81126777
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- MeSH Heading (Major)
- Breast Neoplasms|MO/PA/*SU; Carcinoma|MO/PA/*SU; Carcinoma,
Intraductal, Noninfiltrating|*SU
- MeSH Heading
- Carcinoma, Adenoid Cystic|SU; Female; Human; Neoplasm Staging;
Paget's Disease, Mammary|SU; Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0039-6060
- Country of Publication
- UNITED STATES
Record 5 from database: MEDLINE
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- Title
- Conservation surgery and irradiation as an alternative to
mastectomy in the treatment of clinically favorable breast cancer.
- Author
- Montague ED; Ames FC; Schell SR; Romsdahl MM
- Address
-
- Source
- Cancer, 1984 Dec, 54:11 Suppl, 2668-72
- Abstract
- The combination of conservation surgery and radiation therapy for
early breast cancer is gaining acceptance as an alternative to
radical mastectomy. This article reviews the results of randomized
trials showing that there is no advantage to a radical mastectomy in
patients with early breast cancer. In addition, the article will
review multiple reports concerning the local and regional tumor
control and survival of patients treated with conservation surgery
and irradiation as well as a comparison of 1073 patients with TIS T1
T2 N0 N1 breast cancer treated at University of Texas (UT) M. D.
Anderson Hospital between 1955 and 1980, of whom 345 were treated
with conservation surgery and irradiation and 728 were treated with
radical or modified radical mastectomy alone. The locoregional
recurrence in the patients treated with an intact breast is 4.9%,
and 5.6% in patients treated with radical or modified radical
mastectomy. There is no significant difference in the 10-year
disease-free survival rates between the two groups of patients. In
addition, a comparison of 2467 patients with Stage I and Stage II
breast cancer treated at the UT M. D. Anderson Hospital shows no
significant difference in the incidence of consecutive second breast
carcinoma as a result of the use of radiation therapy in the
treatment of the first breast cancer.
- Language of Publication
- English
- Unique Identifier
- 85048602
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- MeSH Heading (Major)
- Breast Neoplasms|RT/*TH; Mastectomy|*
- MeSH Heading
- Clinical Trials; Combined Modality Therapy; Female; Human;
Neoplasm Recurrence, Local; Support, U.S. Gov't, P.H.S.
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 6 from database: MEDLINE
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- Title
- Free radicals in cancer.
- Author
- Swartz HM
- Address
-
- Source
- Ciba Found Symp, 1978, :67, 107-30
- Abstract
- It has been hypothesized that free radicals play a significant
role in cancer. A historical review indicates a series of rises and
falls in the acceptance of this hypothesis and it remains
controversial. The strongest evidence for a critical role of free
radicals in cancer is based on electron spin resonance (e.s.r.) data
from lyophilized (freeze-dried) tumours. Recent results indicate
that such data are artifactual in the sense that the observed
signals are not directly related to free radicals existing before
lyophilization. These data also indicate, however, that some of the
observed changes are reproducible and may be indirectly linked to
biophysical or biochemical changes that occur in tumour cells. A
possible key to such a link is via antioxidants, especially ascorbic
acid. It is now feasible to do experiments to definitively
determine: (1) the generality of the effect of lyophilization on
e.s.r. spectra of tumours; (2) the molecular nature of the free
radicals observed in lyophilized tumours and normal tissues; (3) the
effect of redox reactions and substances on the observed e.s.r.
spectra; and (4) the occurrence of free radical changes during
carcinogenesis.
- Language of Publication
- English
- Unique Identifier
- 80068416
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- MeSH Heading (Major)
- Free Radicals|*; Neoplasms|*ET/HI
- MeSH Heading
- Animal; Carcinogens; Cell Transformation, Neoplastic; DNA|GE;
Electron Spin Resonance Spectroscopy; Female; History of Medicine,
20th Cent.; Human; Kinetics; Mice; Models, Biological; Neoplasms,
Experimental|ET; Neoplasms, Radiation-Induced; Rats; Support, U.S.
Gov't, P.H.S.
- Publication Type
- HISTORICAL ARTICLE; JOURNAL ARTICLE
- ISSN
- 0300-5208
- Country of Publication
- NETHERLANDS
Record 7 from database: MEDLINE
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- Title
- Conservation surgery and radiation therapy in the treatment of
operable breast cancer.
- Author
- Montague ED
- Address
-
- Source
- Cancer, 1984 Feb, 53:3 Suppl, 700-4
- Abstract
- The combination of conservation surgery and radiation therapy for
favorable breast cancer is gaining acceptance as an alternative to
radical mastectomy. Presented here is a review of the local and
regional tumor control and survival results of several authors, as
well as a comparison of 1073 patients with clinically favorable
breast cancer treated at the University of Texas M. D. Anderson
Hospital between 1955 and 1980, 345 of whom have been treated with
conservation surgery and irradiation and 728 of whom have been
treated with radical or modified radical mastectomy alone. The
locoregional recurrence in the patients treated with an intact
breast is 4.9%, and 5.6% in patients treated with radical or
modified radical mastectomy; there is no significant difference in
the 10-year disease-free survival rates between the two groups. A
detailed analysis of the location and timing of recurrences and the
incidence of contralateral breast cancer is presented.
- Language of Publication
- English
- Unique Identifier
- 84106276
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- MeSH Heading (Major)
- Breast Neoplasms|MO/*RT/*SU
- MeSH Heading
- Female; Follow-Up Studies; Human; Mastectomy|MT; Neoplasm
Recurrence, Local; Neoplasms, Multiple Primary|EP; Radiotherapy|AE;
Radiotherapy Dosage; Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 8 from database: MEDLINE
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- Title
- A randomized prospective trial of radical (Halsted) mastectomy
versus modified radical mastectomy in 311 breast cancer patients.
- Author
- Maddox WA; Carpenter JT Jr; Laws HL; Soong SJ; Cloud G; Urist MM;
Balch CM
- Address
-
- Source
- Ann Surg, 1983 Aug, 198:2, 207-12
- Abstract
- This study reports the results of a prospectively randomized trial
for treatment of carcinoma of the breast comparing standard (Halsted)
radical mastectomy to a modified radical mastectomy. Three hundred
eleven patients with primary operable carcinoma of the breast were
entered in a surgical and adjunctive chemotherapy trial in Alabama
between 1975 and 1978. A total of 91 surgeons participated (all
Diplomats of the American Board of Surgery and Members of the
American College of Surgeons). All operative reports, pathology and
therapy were reviewed by referees. Histologically node positive
patients were randomized after operation to receive melphalan or
C.M.F.(cytoxan, methotrexate, and 5-FU) for 1 year. After a median
follow-up of 5.5 years, there was no significant difference in
disease-free survival or in overall survival between the two groups.
There was a trend toward improved 5-year survival rates in the
radical mastectomy group compared to the modified radical mastectomy
group (84% vs. 76%, p = 0.14). There was also an increased incidence
of local wound recurrence in those patients receiving modified
radical mastectomy, but the differences were not statistically
significant (p = 0.09). Longer follow-up will be necessary to
evaluate these results more fully.
- Language of Publication
- English
- Unique Identifier
- 83255446
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- MeSH Heading (Major)
- Breast Neoplasms|DT/MO/PA/*SU; Mastectomy|MT/*ST
- MeSH Heading
- Drug Therapy, Combination; Female; Human; Lymphatic Metastasis;
Middle Age; Neoplasm Recurrence, Local; Prospective Studies; Quality
Control; Random Allocation; Support, U.S. Gov't, P.H.S.
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0003-4932
- Country of Publication
- UNITED STATES
Record 9 from database: MEDLINE
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- Title
- Radiotherapy combined with surgery as treatment for advanced
cervical cancer.
- Author
- Perches RD; Lobaton AT; Garcia MC
- Address
-
- Source
- Int J Radiat Oncol Biol Phys, 1983 Dec, 9:12, 1785-8
- Abstract
- Experience obtained in a group of 44 patients with advanced
cervical cancer is reported here. In this study, patients with
residual cancer underwent laparotomy eight weeks after one or two
different radiotherapy protocols. Sixty-eight percent of patients
underwent radical surgery, 85% of patients pelvic exenterations, and
15% radical hysterectomies. In 27% of patients, no evidence of
residual cancer was found in surgical specimens. Radical surgery was
well tolerated, and one-third of patients were free of disease for
one year or more. Control of disease was obtained in 50% of pelvic
exenterations and in 60% of radical hysterectomies, regardless of
prognosis, clinical stage or radiotherapy scheme. Although results
show an improvement of up to 22% when comparing this to other more
conventional treatments, we have concluded that we must obtain a
wider experience in order to support our findings.
- Language of Publication
- English
- Unique Identifier
- 84111124
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- MeSH Heading (Major)
- Cervix Neoplasms|MO/*RT/SU
- MeSH Heading
- Adult; Aged; Brachytherapy; Combined Modality Therapy; Female;
Human; Hysterectomy; Lymphatic Metastasis; Middle Age; Neoplasm
Staging; Pelvic Exenteration|MO; Radioisotope Teletherapy;
Radiotherapy Dosage
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0360-3016
- Country of Publication
- UNITED STATES
Record 10 from database: MEDLINE
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- Title
- Adjuvant chemotherapy for bladder cancer with doxorubicin
hydrochloride and cyclophosphamide: preliminary report.
- Author
- Merrin C; Beckley S
- Address
-
- Source
- J Urol, 1978 Jan, 119:1, 62-3
- Abstract
- We describe 25 patients with bladder cancer who received adjuvant
chemotherapy with doxorubicin hydrochloride and cyclophosphamide
after radical cystectomy. Two patients had stage A disease, 3 had
stage B, 3 had stage C and 17 had stage D. The 2 patients with stage
A tumors have been free of disease for 12 and 15 months,
respectively, and the 3 patients with stage B tumors have been free
of disease for an average of 25 months. Of the 3 patients with stage
C tumors 2 have been free of disease for an average of 34.5 months.
Of the 17 patients with stage D tumors 10 have been free of disease
for an average of 1 year (59 per cent). These preliminary results
seem to indicate the value of adjuvant chemotherapy with doxorubicin
hydrochloride and cyclophosphamide in cases of bladder cancer.
- Language of Publication
- English
- Unique Identifier
- 78089762
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- MeSH Heading (Major)
- Bladder Neoplasms|*DT/SU; Cyclophosphamide|AE/*TU; Doxorubicin|AE/*TU
- MeSH Heading
- Drug Therapy, Combination; Human; Time Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0022-5347
- Country of Publication
- UNITED STATES
Record 11 from database: MEDLINE
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- Title
- Treatment results in males with breast cancer.
- Author
- Robison R; Montague ED
- Address
-
- Source
- Cancer, 1982 Jan, 49:2, 403-6
- Abstract
- Between 1948 and 1978, 39 previously untreated males with breast
cancer received curative treatment at M. D. Anderson Hospital; an
additional 30 males were referred for first treatment failure after
outside definitive treatment. Of 21 patients who were treated with
mastectomy, six had radical mastectomy alone, and 15 had radical
mastectomy and postoperative irradiation. Of 18 patients who had
less than radical surgery and postoperative irradiation to the chest
wall and peripheral lymphatic areas, 7 had simple mastectomy, 3
excision biopsy and 8 had needle biopsy. Chest wall recurrences
developed in four of six patients with grave signs treated with
radical mastectomy, one had a recurrence in an unirradiated chest
wall following peripheral lymphatic irradiation and three others had
orthovoltage irradiation of 2400, 3000, and 4200 rad. No local or
regional recurrences had developed in patients treated with simple
mastectomy, excision, or needle biopsy, and radiation therapy to the
chest wall and peripheral lymphatics. The ten-year disease-free
survival (Kaplan-Meier) is 50% for the entire group, 70% for
patients with histologically or a clinically negative axilla, and
34% for those patients with histologically or clinically positive
axilla. Recommendations for the management of primary and regional
disease are reviewed.
- Language of Publication
- English
- Unique Identifier
- 82093114
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- MeSH Heading (Major)
- Breast Neoplasms|PA/RT/*SU
- MeSH Heading
- Adult; Aged; Axilla; Human; Lymphatic Metastasis; Male;
Mastectomy; Middle Age; Neoplasm Recurrence, Local; Support, U.S.
Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 12 from database: MEDLINE
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- Title
- Axillary dissection in breast cancer revisited.
- Author
- Mattheiem W; Bourgeois P; Delcorde A; Stegen M; Frühling J
- Address
- Breast and Pelvis Surgery Clinic, Institut Jules Bordet,
Bruxelles, Belgium.
- Source
- Eur J Surg Oncol, 1989 Dec, 15:6, 490-5
- Abstract
- The pathological status of the axillary nodes remains the single
most determining factor for survival, local recurrence and
disease-free interval in operable breast cancer. Radical axillary
dissection results in better local control with or without
systemic disease in all operable cases. In pathologically negative
cases, radical axillary dissection decreases local recurrence
rates and perhaps prolongs disease-free survival. In
pathologically positive cases, radical axillary dissection
improves local control only. Radical axillary dissection avoids
axillary irradiation and so decreases the risk and the importance
of lymphoedema. Perfect axillary dissection does not show a
decisive advantage over less complete axillary dissection when the
'quality' of surgery is measured by lymphoscintigraphy, but it
should be kept in mind that only total control of the local
situation can ensure a patient free of distal spread at the time
of first therapy.
- Language of Publication
- English
- Unique Identifier
- 90092587
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- MeSH Heading (Major)
- Breast Neoplasms|MO/PA/*SU; Lymph Node Excision|*
- MeSH Heading
- Axilla; Female; Follow-Up Studies; Human; Lymph Nodes|RI;
Lymphatic Metastasis; Mastectomy, Modified Radical; Neoplasm
Recurrence, Local|EP; Neoplasm Staging; Technetium Tc 99m Sulfur
Colloid|DU
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0748-7983
- Country of Publication
- ENGLAND
Record 13 from database: MEDLINE
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- Title
- Measuring oxidative damage in humans: relation to cancer and
ageing.
- Author
- Ames BN
- Address
- Department of Biochemistry, University of California, Berkeley.
- Source
- IARC Sci Publ, 1988, :89, 407-16
- Abstract
- Many uncertainties remain about the free-radical theory of
ageing and the role of oxidative damage to DNA in cancer. The
chemistry and biochemistry of radical-induced DNA damage are now
well characterized in vitro, but the complexity of in-vivo systems
leaves this area still largely unexplored. Measurement of thymine
and thymidine glycols in urine may be a means of assaying
background levels of radical-induced DNA damage in live organisms.
Similar approaches may prove useful for testing some of the
predictions of the free-radical theory of ageing and of the
contribution of free radicals to cancer.
- Language of Publication
- English
- Unique Identifier
- 89065926
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- MeSH Heading (Major)
- Aging|*; DNA Damage|*; Neoplasms|*ET
- MeSH Heading
- Antioxidants|PD; Deoxyguanosine|AA/UR; Free Radicals; Human;
Lipid Peroxides|AN; Oxidation-Reduction; Support, U.S. Gov't,
P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0300-5038
- Country of Publication
- FRANCE
Record 14 from database: MEDLINE
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- Title
- Breast conservation in the treatment of early breast cancer. A
20-year follow-up.
- Author
- Osborne MP; Ormiston N; Harmer CL; McKinna JA; Baker J; Greening
WP
- Address
-
- Source
- Cancer, 1984 Jan, 53:2, 349-55
- Abstract
- Two hundred sixty-three patients with unilateral primary breast
cancer, treated by local excision of the primary tumor and radical
radiation therapy between 1954 and 1969, were followed up for a
minimum of 10 years and a maximum of 20 years. The treatment plan
delivered 4500 rad in fractions of orthovoltage irradiation to
five fields: tangential breast fields, axilla with posterior
axillary field, parasternal and supraclavicular, with a subsequent
boost of 1000 rad to the primary tumor site, axilla, and
supraclavicular fossa. Patients were clinically staged using the
TNM (UICC) system; 115 patients had tumors less than 2 cm in
diameter and a clinically negative axilla (T1N0N1a), 96 had tumors
2 to 5 cm in diameter with a clinically negative axilla (T2N0N1a),
and 52 had tumors less than 5 cm in diameter and clinical axillary
lymph node metastases (T1T2N1b). The actuarial relapse-free
survival of patients with T1N0N1a tumors was 72% at 5 years, 59%
at 10 years, and 47% at both 15 and 20 years. The relapse-free
survival of patients with T2N0N1a tumors was not statistically
different (P greater than 0.05). A significantly worse survival
was observed in patients with clinical axillary lymph node
metastases (T1T2N1b), with a survival of 37% at 5 years, 29% at 10
years, 23% at 15 years, and 22% at 20 years, when compared with
patients with clinically negative lymph nodes (P less than 0.01).
Locoregional relapse occurred in 22%, at 10 years, of those
patients with T1 or T2N0N1a tumors and 52% of the patients with
T1T2N1b tumors. The pattern of locoregional relapses indicated
that approximately 50% occur at least 5 years after treatment;
this contrasts with the pattern of early locoregional relapse
after mastectomy. The commonest sites of relapse were in the
breast in 19% and axilla in 6% of patients with T1 or T2N0N1a
tumors. There was no attenuation of the radiation dose
administered at the site of a subsequent relapse. Surgery for
radiation failure produced a 42% crude relapse-free survival at 5
years after salvage mastectomy in those patients originally
treated for T1 or T1N0N1a tumors. The results of this study
suggest that a significant proportion of patients relapse locally
over a prolonged period after breast conservation. The evolution
of new radiation techniques may provide better locoregional
control and early salvage surgery may result in improved long-term
survival.
- Language of Publication
- English
- Unique Identifier
- 84081789
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- MeSH Heading (Major)
- Breast Neoplasms|RT/*SU; Mastectomy|*MT
- MeSH Heading
- Adult; Aged; Combined Modality Therapy; Female; Follow-Up
Studies; Human; Middle Age; Neoplasm Recurrence, Local; Neoplasm
Staging; Time Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 15 from database: MEDLINE
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- Title
- Intermediate-term survival results in clinically understaged
prostate cancer patients following radical prostatectomy [see
comments]
- Author
- Catalona WJ; Miller DR; Kavoussi LR
- Address
- Division of Urologic Surgery, Washington University School of
Medicine, St. Louis, Missouri.
- Source
- J Urol, 1988 Sep, 140:3, 540-3
- Abstract
- To determine the natural history of clinically understaged
prostatic cancer patients who were followed without adjuvant
therapy for at least 6 years after radical prostatectomy we
reviewed the clinical courses of 21 patients (1 with clinical
stage A and 20 with clinical stage B disease). All patients
underwent radical retropubic prostatectomy and 9 had pathological
stage C disease (6 with capsular penetration only and 3 with
seminal vesicle invasion). A total of 12 patients had pathological
stage D1 disease by virtue of positive nodes on permanent sections
after frozen sections were read as negative. Among the patients
with pathological stage C disease 67 per cent were free of
recurrence 6 years after radical prostatectomy. Of the patients
with seminal vesicle invasion 33 per cent had recurrence compared
to 17 per cent of those with capsular penetration only. Among the
12 stage D1 cancer patients 75 per cent were free of recurrence at
6 years. In both groups patients who were followed beyond 7 years
had a diminished survival free of tumor owing to late tumor
recurrences. The results indicate that the intermediate survival
rates free of tumor in patients with clinically understaged A or B
prostatic cancer are remarkably good without adjuvant therapy.
However, survival without recurrence appears to decrease after 7
years. All patients who failed treatment did so distantly; no
patient failed with local recurrence alone. These results may be
important in the evaluation of adjuvant therapy protocols
currently under investigation for patients with clinically
understaged prostate cancer.
- Language of Publication
- English
- Unique Identifier
- 88317075
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- MeSH Heading (Major)
- Adenocarcinoma|*MO/PA/SU; Prostatectomy|*; Prostatic Neoplasms|*MO/PA/SU
- MeSH Heading
- Aged; Human; Male; Middle Age; Neoplasm Recurrence, Local
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0022-5347
- Country of Publication
- UNITED STATES
Record 16 from database: MEDLINE
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- Title
- Surgical management of primary breast cancer.
- Author
- Kinne DW
- Address
-
- Source
- Cancer, 1983 Jun, 51:12 Suppl, 2540-6
- Abstract
- The approach to primary operable, or potentially curable breast
cancer is a controversial field of oncology and is subject to a
number of ongoing clinical experiments in many centers. This
report discusses the recommended treatment for patients with this
disease who are evaluated at the Breast Service of Memorial
Sloan-Kettering Cancer Center. The most widely practiced treatment
is modified radical mastectomy, with radical mastectomy reserved
for patients having more advanced lesions. Modified radical
mastectomy is defined as total mastectomy plus axillary lymph node
dissection either with preservation of the pectoralis minor muscle
or its removal. The latter allows a more thorough axillary
dissection and is preferred for patients with invasive carcinomas.
In either case, axillary node sampling is not advocated and will
miss a significant percentage of axillary metastases. In patients
with negative axillary lymph nodes, who are not candidates for
adjuvant systemic therapy, breast reconstruction is possible
within a few months of mastectomy. For patients with involved
axillary nodes, trials of adjuvant chemotherapy (perhaps with
antiestrogen therapy for estrogen-receptor positive primary
tumors) seem to offer the best hope for improved survival. With
available follow-up of such trials to date, there seems little
doubt that at a minimum, such treatment prolongs disease-free
interval. The role of adjuvant radiation therapy is more
controversial, and the difficulty in combining this with
chemotherapy is apparent.
- Language of Publication
- English
- Unique Identifier
- 83206395
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- MeSH Heading (Major)
- Breast Neoplasms|MO/PX/*SU; Mastectomy|*MT
- MeSH Heading
- Axilla; Female; Follow-Up Studies; Human; Lymph Node Excision;
Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm
Staging; Prognosis; Time Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 17 from database: MEDLINE
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- Title
- Surgery for colorectal cancer metastatic to the liver.
Optimizing the results of treatment.
- Author
- Hughes K; Scheele J; Sugarbaker PH
- Address
- Lahey Clinic Foundation, Burlington, Massachusetts.
- Source
- Surg Clin North Am, 1989 Apr, 69:2, 339-59
- Abstract
- Overall, hepatic resection appears to be an important means of
curing patients with metastatic colorectal cancer isolated to the
liver. The only absolute contraindication to surgery was the
impossibility of a radical removal of tumor: if residual disease
will remain after the hepatic resection, this operation is not
indicated. A possible second contraindication to surgery is the
presence of tumor in the hepatic or celiac lymph nodes. Such
metastases from liver metastases signal a biologic grade of tumor
that is almost sure to spread to other sites. However, one patient
of the 25 in this group did survive long term when positive lymph
node groups were dissected. Further clinical experience with this
form of the disease along with trials of regional adjuvant
therapies such as intraperitoneal chemotherapy may be needed. The
presence of extrahepatic metastases at the time of liver resection
should be considered a relative contraindication to this surgery,
but if the patient can be made clinically disease free, long-term
disease-free survival may result. It seems imperative that all
patients with hepatic metastases be evaluated by an experienced
hepatic surgeon for a curative resection. If the patient has
between one and four metastases, a 25 per cent long-term
disease-free survival rate can be expected. Patients who have a
radical resection of more than four metastases should be
considered to be in an experimental group in whom more data are
needed. In our current state of knowledge, making such patients
clinically disease free is their only chance for long-term
survival. Other factors besides the number of metastases that will
affect the prognosis of the patient include the disease-free
interval between colorectal resection and liver resection, the
pathologic margin of resection on the liver specimen, and the
presence or absence of mesenteric lymph node metastases from the
primary cancer. These factors should be considered when
determining the prognosis in a given patient and should be used as
stratification variables in prospective trials. However, from our
analysis of available data, these factors should not be considered
contraindications to hepatic resection.
- Language of Publication
- English
- Unique Identifier
- 89187311
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- MeSH Heading (Major)
- Colorectal Neoplasms|MO/*SU; Liver Neoplasms|MO/*SC/SU
- MeSH Heading
- Adult; Age Factors; Aged; Carcinoembryonic Antigen|AN; Female;
Human; Male; Middle Age; Neoplasm Staging; Prognosis; Registries
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0039-6109
- Country of Publication
- UNITED STATES
Record 18 from database: MEDLINE
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- Title
- Management of elderly patients with primary breast cancer.
- Author
- Toonkel LM; Fix I; Jacobson LH; Bamberg N
- Address
- Department of Radiation Oncology, Mount Sinai Medical Center,
Miami Beach, FL.
- Source
- Int J Radiat Oncol Biol Phys, 1988 Apr, 14:4, 677-81
- Abstract
- From 1974 through 1983, three hundred forty-three patients aged
70 years or older at diagnosis received comprehensive
post-operative radiation therapy for localized (Stage I-III)
breast cancer following surgical procedures ranging from
incisional biopsies to classical radical mastectomy. The 5- and
10-year overall survival rates for this series of elderly patients
are 67% and 33%. The respective disease-free survival rates are
67% and 42%. Over one-half of these women were treated by less
than total mastectomy. No differences were seen in survival,
disease-free survival, or local regional control rates comparing
similarly staged patients treated by radical mastectomy, modified
radical mastectomy, or tylectomy. Complications were few and seen
primarily in those patients subjected to axillary dissection prior
to irradiation. Long term survival appears to be achievable in the
majority of elderly patients with regionally confined disease at
presentation and aggressive treatment with curative intent is
warranted. These elderly patients are often poor candidates for
radical surgery. In this patient population, conservative surgery
with post-operative radiation therapy is well tolerated and
provides equivalent results to more radical surgical procedures.
- Language of Publication
- English
- Unique Identifier
- 88169261
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- MeSH Heading (Major)
- Breast Neoplasms|PA/*RT/SU
- MeSH Heading
- Age Factors; Aged; Aged, 80 and over; Female; Follow-Up Studies;
Human; Mastectomy; Neoplasm Staging
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0360-3016
- Country of Publication
- UNITED STATES
Record 19 from database: MEDLINE
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- Title
- Lobectomy with bronchoplastic procedures for lung cancer.
- Author
- Valente M; Grandi C; Cataldo I; Pizzocaro G; Ravasi G
- Address
-
- Source
- Tumori, 1979 Oct, 65:5, 643-8
- Abstract
- From April 1970 to October 1977, 19 patients with lung cancer of
the upper lobar bronchus orifice underwent radical lobectomy with
major bronchus resection. Sleeve lobectomy was accomplished in 11
cases and wedge lobectomy in the remaining 8. The length of the
free bronchial margin in the surgical specimen was less than 1 cm
in 3 cases, but limited pulmonary reserve did not allow
pneumonectomy. Squamous carcinoma was diagnosed in 14 patients,
adenocarcinoma in 2, oat-cell carcinoma in 2, and large cell
carcinoma in one. Most cases (70%) were pathological stage I.
There was one operative death due to anastomotic leakage (5%), and
another patient required pneumonectomy completion. Of 13 patients
with non oat-cell carcinoma and adequate bronchial resection, none
had local recurrence: 3 patients developed distant metastases, and
10 are alive and disease-free after a follow-up period ranging
from 16 to 104 months. The authors conclude that in selected lung
cancer patients lobectomy with bronchoplastic procedures is
superior to pneumonectomy for tissue sparing advantages.
- Language of Publication
- English
- Unique Identifier
- 80082653
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- MeSH Heading (Major)
- Lung Neoplasms|SC/*SU; Pneumonectomy|AE/*MT
- MeSH Heading
- Adenocarcinoma|SU; Adult; Aged; Atelectasis|ET; Bronchi|SU;
Carcinoma, Small Cell|SU; Carcinoma, Squamous Cell|SU; Female;
Human; Male; Middle Age; Postoperative Complications; Remission,
Spontaneous
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0300-8916
- Country of Publication
- ITALY
Record 20 from database: MEDLINE
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- Title
- The detection and diagnosis of early, occult and minimal
breast cancer.
- Author
- Hickey RC; Gallager HS; Dodd GD; Samuels BI; Paulus DD Jr;
Moore DL
- Address
-
- Source
- Adv Surg, 1976, 10:, 287-312
- Abstract
- Radical mastectomy as originally conceived at the turn of the
century consisted of complete removal of the breast tissue, the
overlying skin, the pectoral muscles, the intervening lymphatics
and the axillary lymph nodes. The aim was logical but initially
the results were poor. Only 41% of the 76 patients in Halsted's
original series were without disease at the end of 3 years. The
principal reason for this was the advanced stage of disease in
the patients selected for treatment. By contrast, Gilbertsen,
using clinical examination alone, surveyed women 45 years of age
or older and found that of 32 patients with breast cancers
detected by the screening procedure, 24 had no axillary lymph
node involvement. The absolute 5-year survival rate of this
group was 96%, which approaches the anticipated survival of
comparable women free of breast cancer. Those with positive
lymph nodes had an absolute survival rate of 75% at 5 years.
Further, of 13 patients observed for 10 years, the survival rate
for those without node involvement was 90% and for patients with
node involvement was 33%. Patients treated at the Barnes
Hospital in St. Louis between 1912 and 1933 were contrasted with
similarly treated patients at the Barnes Hospital and the Ellis
Fischel Cancer Hospital from 1940 to 1955. A poorer survival
rate in the earlier series was related primarily to the greater
frequency of advanced and larger tumors. That a significant
reduction in breast cancer mortality can be achieved is becoming
increasingly apparent. Among survey-detected breast cancers in
the study conducted by the Health Insurance Plan of Greater New
York, the 6-year mortality was half of that of controls. This
reduction is even more impressive when one considers that among
these patients were many with full invasive, mass-forming
carcinomas at the time of initial screening. A recent report by
Wanebo, Huvos and Urban discusses the treatment of
prognostically favorable forms of breast cancer by modified
radical mastectomy. It is possible to select from among their
patients those who fit the definition of minimal breast cancer.
In this group the 5-year survival rate was 97% and the 10-year
survival rate was 95%. Only 1 patient died of breast cancer in
10 years. In another reported group of 65 patients with
intraductal carcinoma only, there were no deaths due to breast
cancer in 10 years. Should the NCI-ACS demonstration projects
show, as now seems probable, that community screening programs
can be effective in early breast cnacer detection, it is to be
anticipated that widespread public demand for screening
facilities will follow. This may present insurmountable logistic
and economic problems. The total number of radiologists in the
United States is not sufficient to screen annually the total
population of women over age 40, or even over age 50. There is
great need for the development of criteria for the ready
identification of that segment of the population in which most
of the cancers would be found...
- Language of Publication
- English
- Unique Identifier
- 77041764
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- MeSH Heading (Major)
- Breast Neoplasms|*DI/PA/RA
- MeSH Heading
- Adult; Biopsy|MT; Breast|PA; Carcinoma|DI/PA; Carcinoma in
Situ|PA; Carcinoma, Intraductal, Noninfiltrating|DI/PA;
Diagnostic Errors; Female; Human; Lymphatic Metastasis;
Mammography; Mass Screening; Middle Age; Neoplasm Invasiveness;
Palpation; Thermography; Xeroradiography
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0065-3411
- Country of Publication
- UNITED STATES
Record 21 from database: MEDLINE
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- Title
- Adjuvant chemotherapy with doxorubicin (Adriamycin) and
5-fluorouracil in T3, NX, MO bladder cancer treated with
radiotherapy.
- Author
- Richards B; Bastable JR; Freedman L; Glashan RW; Harris G;
Newling DW; Robinson MR; Smith PH
- Address
-
- Source
- Br J Urol, 1983 Aug, 55:4, 386-91
- Abstract
- Radical radiotherapy alone has been compared with radical
radiotherapy followed by chemotherapy using doxorubicin (Adriamycin)
and 5-fluorouracil in a randomised prospective study on 129
patients presenting with T3, NX, MO transitional cell carcinoma
of the bladder. One hundred and ten patients were evaluable with
a minimum follow-up of 2 years. The addition of this form of
chemotherapy did not appear to influence the survival rate or
the proportion of patients free from tumour. It cannot be
recommended for routine use in the primary treatment of
infiltrating bladder cancer.
- Language of Publication
- English
- Unique Identifier
- 83284082
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- MeSH Heading (Major)
- Bladder Neoplasms|*DT/MO/RT; Carcinoma, Transitional
Cell|*DT/MO/RT; Doxorubicin|*AD; Fluorouracil|*AD
- MeSH Heading
- Clinical Trials; Comparative Study; Drug Therapy, Combination;
Female; Human; Male; Middle Age; Neoplasm Recurrence, Local;
Random Allocation; Support, Non-U.S. Gov't; Time Factors
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0007-1331
- Country of Publication
- ENGLAND
Record 22 from database: MEDLINE
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- Title
- CT of the normal and abnormal parametria in cervical cancer.
- Author
- Vick CW; Walsh JW; Wheelock JB; Brewer WH
- Address
-
- Source
- AJR Am J Roentgenol, 1984 Sep, 143:3, 597-603
- Abstract
- To evaluate CT criteria for differentiating a cervical cancer
confined to the cervix from a lesion that invades the parametria,
16 patients with newly diagnosed, untreated cervical cancer were
studied with CT. Twenty-five parametria were confirmed by
radical hysterectomy, transvaginal parametrial fine-needle
aspiration cytology, or excretory urography. In eight tumor-free
parametria, CT findings indicating confined tumor were: (1)
smooth, well defined cervical margins; (2) lack of prominent
parametrial soft-tissue strands; (3) no parametrial soft-tissue
mass; and (4) preservation of the periureteral fat plane. The
simultaneous occurrence of these four findings was seen in six
of eight tumor-free parametria and in no tumor-infiltrated
parametria. In 17 tumor-positive parametria, CT findings
associated with parametrial tumor invasion were: (1)
irregularity or poor definition of the lateral cervical margins;
(2) prominent parametrial soft-tissue strands; (3) obliteration
of the periureteral fat plane; and (4) an eccentric parametrial
soft-tissue mass. The latter two findings were seen only in
tumor-positive parametria. Irregularity of the cervical margins
and prominent parametrial strands were seen most commonly with
parametrial tumor invasion, but were also occasionally seen with
parametrial inflammation. On the basis of the criteria developed
in this report, CT may be used as an adjunct to the physical
examination in differentiating stage I cervical cancer from more
advanced disease in selected patients.
- Language of Publication
- English
- Unique Identifier
- 84277323
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- MeSH Heading (Major)
- Adnexa Uteri|*RA; Carcinoma, Squamous Cell|*RA; Cervix
Neoplasms|*RA; Tomography, X-Ray Computed|*
- MeSH Heading
- Adult; Cervix Uteri|AH; Female; Human
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0361-803X
- Country of Publication
- UNITED STATES
Record 23 from database: MEDLINE
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- Title
- Cancer of the breast. Staging methods, primary treatment
options and end results.
- Author
- Donegan WL
- Address
-
- Source
- Major Probl Clin Surg, 1979, 5:, 221-301
- Abstract
- A totally satisfying concept of treatment is not easy to
formulate from the complex and often conflicting results of
local therapeutic interventions for breast cancer. It seems
evident that clinically occult cancer is often beyond the pale
of both resection and irradiation at primary treatment,
particularly when cancer is found in regional lymph nodes.
Despite all combinations of local treatment, the ultimate risk
of failure correlates more closely with the stage of the disease
at the time of treatment than with the particular form of
treatment. Thus the extent of disease must be considered the
major, perhaps the ultimate determinant of prognosis. Because,
under controlled conditions, several therapeutic alternatives
have appeared to provide virtually identical end results in
terms of survival and ultimate dissemination of the disease, the
adequacy of control within the field of treatment may, in fact,
be the most meaningful end result of local treatment. The
experience that has accumulated with treatment of breast cancer
supports the thesis that removal of the breast accomplishes all
that can be achieved in terms of curing the disease, and wider
treatment with surgery or irradiation serves only to improve the
prospects for local control. Halsted demonstrated this principle
with his radical mastectomy and it still seems to be the case.
This fact provides further impetus for detecting and treating
cancer while it is still localized to the breast. With these
generalizations in mind some empirical observations can be
added. An anatomic fact is that multiple microscopic foci of
cancer that are not evident clinically are often present in the
mammary parenchyma. Undisturbed, at least some, and perhaps
eventually all, of these foci of cancer progress to become
clinical cancers. Thorough removal of the entire breast (the
entire mammary parenchyma) eliminates this particular hazard
and, one may presume, terminates the disease if it is still
limited to the breast. Removal of the underlying pectoralis
major muscle provides additional margin around the tissues
primarily involved, but sacrific of the muscle is apparently
needless unless it is directly invaded by cancer. Microscopic
metastases are also often present in regional lymph nodes
without being clinically detectable and, left untreated, have
the capacity to enlarge and become clinically apparent. Routine
wide removal of regional lymph nodes improves the control of
cancer at these sites when metastases are present, but whether
it improves the chances for cure is doubtful. The fact is that
approximately 25 per cent of patients with axillary metastases
enjoy prolonged survival free of recurrence, some remaining well
even after thirty years (Adair et al., 1974). Whether they would
survive as well without removal of the metastases is uncertain.
Desease-free survival is highest if metastases are removed while
still microscopic, but this phenomenon may simply reflect
treatment at an earlier phase in the evolution of the disease...
- Language of Publication
- English
- Unique Identifier
- 79220047
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- MeSH Heading (Major)
- Breast Neoplasms|*PA/RA/TH
- MeSH Heading
- Bone and Bones|RI; Brain|RI; Female; Human; Liver|RI; Liver
Function Tests; Lymphatic Metastasis; Mastectomy|MT; Neoplasm
Metastasis; Neoplasm Staging|MT; Prognosis
- Publication Type
- JOURNAL ARTICLE; REVIEW
- ISSN
- 0025-1062
- Country of Publication
- UNITED STATES
Record 24 from database: MEDLINE
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- Title
- Invasive cervical cancer in young women.
- Author
- la Vecchia C; Franceschi S; Decarli A; Gallus G; Parazzini F;
Merlo E
- Address
-
- Source
- Br J Obstet Gynaecol, 1984 Nov, 91:11, 1149-55
- Abstract
- Between 1970 and 1979, 103 women below 35 years of age with
invasive cervical cancer were treated at the First Obstetrics
and Gynaecology Clinic of the University of Milan. Nine patients
were pregnant or less than 3 months postpartum. Estimated
10-year disease-free survival, determined by the life-table
method, was 100% in stage IA (37 patients), 79% in stage IB (45
patients), 67% in stage II (15 patients), 0% in stages III (5
patients) and IV (1 patient). Prognosis was also strongly
associated with lymph-node involvement, 10-year actuarial
survival decreasing from 93% in lymph-node-negative to 44% in
lymph-node-positive patients (P less than 0.001). The prognostic
relevance of the clinical stage decreased after adjustment for
lymph-node involvement, but the statistical significance of
lymph-node involvement was unaffected when stage was allowed
for. In the present series, the estimated 10-year disease-free
survival was 80% in patients treated by radical hysterectomy
compared with 62% in the group treated by total hysterectomy
(stage IB to IV patients only); this difference, however, was
not statistically significant when the data were adjusted for
clinical stage (P = 0.10). None of the 20 patients with
recurrent disease could be managed successfully.
- Language of Publication
- English
- Unique Identifier
- 85047102
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- MeSH Heading (Major)
- Adenocarcinoma|*MO/PA/TH; Carcinoma, Squamous Cell|*MO/PA/TH;
Cervix Neoplasms|*MO/PA/TH; Pregnancy Complications, Neoplastic|*MO/PA/TH
- MeSH Heading
- Adult; Age Factors; Female; Human; Neoplasm Staging;
Pregnancy; Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0306-5456
- Country of Publication
- ENGLAND
Record 25 from database: MEDLINE
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- Title
- Total prostatectomy for localized prostatic cancer.
- Author
- Gibbons RP; Correa RJ Jr; Brannen GE; Mason JT
- Address
-
- Source
- J Urol, 1984 Jan, 131:1, 73-6
- Abstract
- Several treatment options currently are available for the
patient with clinically localized carcinoma of the prostate and
each has its proponents. Comparison of results between
institutions becomes necessary to determine the relative value
of these treatments, keeping in mind the absence of a suitable
control group in any series. Such inter-institutional treatment
comparisons are possible only if the patient compositions are
similar in terms of age, grade and extent of disease.
Comparisons of patients with stage B disease frequently are made
because most urologists agree that these patients have palpable
disease confined to the prostate and no evidence of metastasis.
At our clinic willing patients with clinically localized
adenocarcinoma of the prostate who have an expected 15-year
survival are treated preferentially with total prostatectomy. We
summarize our experience with total prostatectomy in 215
consecutive patients, including 213 who were available for
followup. There were 16 patients with clinical stage A, 195 with
clinical stage B and 2 with clinical stage C disease. Of these
patients 207 underwent radical perineal prostatectomy and there
were no operative deaths. Patients did not receive adjuvant
hormonal therapy unless disease recurred. Of the 110 patients
who have undergone the operation within the last 5 years 98 per
cent are alive. Actual survival and survival free of disease,
respectively, for the entire series were 55 and 48 per cent at
15 years, 75 and 67 per cent at 10 years, and 94 and 86 per cent
at 5 years, compared to 55 and 48, 74 and 67, and 95 and 90 per
cent, respectively, for the 195 patients with clinical stage B
disease. We believe these results demonstrate that in terms of
local control of the disease, over-all survival and survival
free of disease total prostatectomy remains the optimal
treatment for patients with clinically localized carcinoma of
the prostate.
- Language of Publication
- English
- Unique Identifier
- 84090469
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- MeSH Heading (Major)
- Adenocarcinoma|*SU; Prostatectomy|*MT; Prostatic Neoplasms|PA/*SU
- MeSH Heading
- Aged; Follow-Up Studies; Human; Impotence|ET; Male; Neoplasm
Staging; Postoperative Complications; Urinary Incontinence|ET
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0022-5347
- Country of Publication
- UNITED STATES
Record 26 from database: MEDLINE
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- Title
- Adjuvant chemo(immuno-)-therapy of primary breast cancer with
adriamycin-cyclophosphamide (and levamisole)--six-year
evaluation.
- Author
- Schreml W; Lang M; Betzler M; Schlag P; Lohrmann HP; Heimpel
H; Herfarth C
- Address
-
- Source
- Eur J Cancer Clin Oncol, 1983 May, 19:5, 607-13
- Abstract
- In a phase II-type study 52 patients with no signs of
metastases but with a high risk of recurrence were treated with
6 courses of adriamycin-cyclophosphamide as adjuvant systemic
therapy following modified radical mastectomy of primary breast
cancer. Half of the patients were randomized to receive
additional immunotherapy with levamisole for 2 yr. The scheduled
dose and time regimen could be achieved in over 90% of patients.
A comparison of the actuarial disease-free and overall survival
with data reported in the literature indicates a similar
positive effect of adjuvant systemic therapy as described in
adjuvant studies using polychemotherapy regimens. Immunotherapy
with levamisole has no effect on disease-free and overall
survival but added to general toxicity. Particular attention was
paid to psychological consequences of adjuvant systemic therapy;
consistent attention by one specifically trained physician
during the whole therapy and follow-up period was effective in
coping with the emotional problems. The difficulties in treating
recurrences after adjuvant therapy became apparent. A high rate
of loco-regional recurrences and of cerebral metastases was
noted.
- Language of Publication
- English
- Unique Identifier
- 83262000
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- MeSH Heading (Major)
- Breast Neoplasms|*DT/MO/PX; Cyclophosphamide|*AD/AE;
Doxorubicin|*AD/AE; Levamisole|*AD/AE
- MeSH Heading
- Drug Evaluation; Drug Therapy, Combination; Female;
Hematologic Diseases|CI; Human; Mastectomy; Neoplasm Recurrence,
Local; Support, Non-U.S. Gov't
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
- Country of Publication
- ENGLAND
Record 27 from database: MEDLINE
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- Title
- The correlation between estrogen receptor status, axillary-node
metastases and disease-free interval after surgery in primary
breast cancer.
- Author
- Caldarola L; Calderini P; Volterrani P; Di Carlo F; Gaglia P
- Address
-
- Source
- Ital J Surg Sci, 1983, 13:3, 179-85
- Abstract
- The prognostic value of estrogen receptor (ER) status in
primary breast cancer was evaluated in 208 women subjected to
Halsted radical mastectomy. The correlation between ER status,
node involvement and disease-free interval after surgery was
analyzed in detail. Forty-seven out of 127 ER-positive
patients received hormonal adjuvant therapy, whereas the 81
ER-negative patients did not. Similar recurrence rates were
found in ER-negative and untreated ER-positive patients,
suggesting that the natural course of disease was not related
to ER status. ER-positive patients who received hormonal
adjuvant therapy showed a significantly longer disease-free
interval than both ER-negative and untreated ER-positive
patients, even though a higher frequency of node involvement
was found in ER-positive tumors. Since only hormone-treated
ER-positive patients showed a significantly lower recurrence
rate, it is felt that ER status cannot be used as an
independent prognostic factor.
- Language of Publication
- English
- Unique Identifier
- 84060859
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- MeSH Heading (Major)
- Breast Neoplasms|AN/*SU; Mastectomy|*; Receptors,
Estrogen|*AN
- MeSH Heading
- Adult; Aged; Axilla; Combined Modality Therapy; Female;
Follow-Up Studies; Human; Lymphatic Metastasis; Middle Age;
Neoplasm Recurrence, Local; Postoperative Period; Prognosis
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0392-3525
- Country of Publication
- ITALY
Record 28 from database: MEDLINE
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- Title
- Tumor recurrence and survival in stage IB cancer of the
cervix.
- Author
- Shingleton HM; Gore H; Soong SJ; Orr JW Jr; Hatch KD; Austin
JM Jr; Partridge EE
- Address
-
- Source
- Am J Clin Oncol, 1983 Jun, 6:3, 265-72
- Abstract
- Clinical records of 371 women with carcinoma of the cervix,
Stage IB, treated in the decade 1969-1979 were reviewed.
Cancer recurred in 67 women (18.1%). A group of 171 patients
treated by radiation, including 25 who were surgically staged
prior to treatment, was compared to 200 patients treated by
radical abdominal hysterectomy and pelvic node dissection,
including 35 who had postoperative whole pelvis radiation. A
multifactorial analysis included time to recurrence, site of
recurrence, treatment for recurrence, and survival after
recurrence. Pathology review and clinicopathological
correlation included tumor configuration, histologic type,
size of tumor in greatest dimension, and rate of node
metastases in patients undergoing either radical hysterectomy
or surgical staging procedures. Lesion size was found to be
the most accurate predictor of disease-free survival; this was
true whether the patient was treated by surgery or radiation
and was not significantly affected by the tumor histology.
Nodal metastases were associated with increasing size of
lesions and predicted high recurrence rates. Node metastasis
rates were not affected by the histology of the tumor.
- Language of Publication
- English
- Unique Identifier
- 83201051
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- MeSH Heading (Major)
- Cervix Neoplasms|*MO/PA/TH; Neoplasm Recurrence, Local|*MO/TH
- MeSH Heading
- Female; Human; Hysterectomy; Lymphatic Metastasis; Pelvic
Neoplasms|SC; Support, U.S. Gov't, P.H.S.; Time Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0277-3732
- Country of Publication
- UNITED STATES
Record 29 from database: MEDLINE
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- Title
- Preoperative chemotherapy followed by mastectomy for locally
advanced breast cancer.
- Author
- Schick P; Goodstein J; Moor J; Butler J; Senter KL
- Address
-
- Source
- J Surg Oncol, 1983 Apr, 22:4, 278-82
- Abstract
- Six patients with advanced local-regional breast cancer were
reviewed. Five out of the six patients previously had had
radiation therapy as part of the initial therapy. All patients
had preoperative cycles of combination chemotherapy, either
CMF or CAF. The two stage III patients had greater than 75%
reduction in measurable tumor mass, which allowed a
conventional modified radical or radical mastectomy to be
performed. Both of these patients are now disease free at 26
and 27 months. The four stage IV patients had lesser
operations following the chemotherapy (two simple
mastectomies, one simple mastectomy plus axillary resection,
and one axillary debulking). Reconstruction utilized
advancement flaps in three patients and split-thickness skin
grafts in the other. None of the patients had postoperative
wound problems, and none of the patients had further problems
with local cancer control. All patients had combination
chemotherapy starting two to six weeks following surgery.
Preoperative chemotherapy followed by surgery plays an
important role in management of locally advanced stage III and
stage IV breast cancer.
- Language of Publication
- English
- Unique Identifier
- 83165573
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- MeSH Heading (Major)
- Adenocarcinoma|*DT/SU; Antineoplastic Agents|*AD; Breast
Neoplasms|*DT/SU; Mastectomy|*
- MeSH Heading
- Adult; Aged; Case Report; Drug Therapy, Combination; Female;
Human; Preoperative Care
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0022-4790
- Country of Publication
- UNITED STATES
Record 30 from database: MEDLINE
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- Title
- Multimodal treatment in operable breast cancer: five-year
results of the CMF programme.
- Author
- Rossi A; Bonadonna G; Valagussa P; Veronesi U
- Address
-
- Source
- Br Med J (Clin Res Ed), 1981 May, 282:6274, 1427-31
- Abstract
- The five-year results of a prospective randomised trial of
radical mastectomy (179 patients) versus radical mastectomy
followed by adjuvant chemotherapy (207 patients) were analysed.
Chemotherapy consisted of 12 monthly cycles of
cyclophosphamide, methotrexate, and fluorouracil (CMF). Both
relapse-free survival (controls 44.6%, CMF group 59.5%) and
total survival (controls 66.2%, CMF group 78.4%) were
significantly improved. The findings were related to the
number of diseased axillary nodes and amount of drug
administered, and were independent of CMF-induced amenorrhoea.
Menopausal state alone appeared to affect the five-year
results only when the amount of drug administered was not
taken into account. Salvage treatment at first relapse failed
to improve total survival in the controls compared with the
CMF group. Acute toxic manifestations were moderate and
reversible. Chronic organ damage and increased incidence of
second neoplasms (controls 1.7%, CMF group 1.4%) were not
observed. The multimodality approach to treatment of primary
breast cancer is a new and important advance. This and other
studies are continuing.
- Language of Publication
- English
- Unique Identifier
- 81185332
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- MeSH Heading (Major)
- Breast Neoplasms|*DT/MO/SU; Cyclophosphamide|*TU;
Fluorouracil|*TU; Methotrexate|*TU
- MeSH Heading
- Adult; Aged; Clinical Trials; Drug Therapy, Combination;
Female; Follow-Up Studies; Human; Mastectomy; Middle Age;
Neoplasm Metastasis; Neoplasm Recurrence, Local; Prospective
Studies; Support, U.S. Gov't, P.H.S.
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0267-0623
- Country of Publication
- ENGLAND
Record 31 from database: MEDLINE
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- Title
- Radiotherapy alone and radiotherapy followed by radical
mastectomy in T2 breast cancer.
- Author
- Zucali R; Volterrani F; Kenda R; Uslenghi C
- Address
-
- Source
- Tumori, 1980 Feb, 66:1, 93-100
- Abstract
- Ninety-four patients with T2 NO, N1a, N1b, MO were treated
with primary radiotherapy (RT) because of old age or poor
general conditions. In 32 patients (34%), younger in age and
in better general conditions, Halsted radical mastectomy could
be performed 5-8 months from starting RT; surgery was not done
at random, but decided case by case on the basis of a good
response to RT and an improvement of general status. Relapse
was documented in 42 patients. Relapse rate was 50% in the
group treated with RT alone (high incidence of breast
recurrences) and 33% in the group operated on after RT.
Distant metastases had the same incidence in the 2 groups,
with a median free interval of 14 months. Overall disease-free
survival rates at 5 to 10 years were 46% and 35%,
respectively; these results are not particularly different
from the data of historical series of T2 breast cancer treated
with surgery alone. The patients operated on after RT had a
significantly better survival, but the results were clearly
influenced by the selection of patients. For the future, a
safe policy could be a conservative combined treatment
consisting of tumorectomy followed by curative RT; adjuvant
medical therapy could be scheduled for high-risk patients
(N1b).
- Language of Publication
- English
- Unique Identifier
- 80192860
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- MeSH Heading (Major)
- Breast Neoplasms|MO/*TH
- MeSH Heading
- Adult; Aged; Cobalt Radioisotopes; Female; Human;
Mastectomy; Menopause; Middle Age; Radiotherapy, High-Energy
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0300-8916
- Country of Publication
- ITALY
Record 32 from database: MEDLINE
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- Title
- Current status and indications for adjuvant therapy in
breast cancer.
- Author
- Senn HJ
- Address
-
- Source
- Cancer Chemother Pharmacol, 1982, 8:2, 139-50
- Abstract
- 1. Modified radical mastectomy is the standard surgical
procedure today in most countries. 'Lesser surgery' associated
with radiotherapy emerges as an alternative for patients with
T1N0 lesions. 2. The potential risk of occult micrometastases
is best predicted by careful axillary staging and possibly by
the ER status of the primary tumor. 3. Additional risk factors
such as tumor size, patients age, menopausal status, and
intramammary lymphatic or vascular invasion are less well
established and need clarification. 4. Previous studies showed
no significant long-term benefit of adjuvant radiotherapy and
at best a marginal increase of lifespan by adjuvant castration
in patients subjected to radical surgery. 5. Various types of
adequately intensive adjuvant chemotherapy resulted in a
significant increase of relapse-free survival and probably
also overall survival 5-6 years after mastectomy in pre- and
possibly also postmenopausal N+ patients. 6. Treatment
intensity (full doses) of adjuvant chemotherapy seems to be
more critical than treatment duration (CMF X 6 is as good as
CMF X 12). 7. Adjuvant chemotherapy with drug combinations is
generally more effective than single drugs. No combination so
far (if adequate doses are given) is clearly superior. 8.
Whether early peri-operative onset of adjuvant chemotherapy or
combinations with endocrine measures or cyclic, alternating
drug regimens increase effectiveness remains to be shown. 9.
Adjuvant chemotherapy in N- patients, though still
experimental, appears rewarding. 10. The pattern of first
relapse has not been significantly altered by the use of
adjuvant chemotherapy. Response rate and duration with
secondary treatments are consistent with common experience in
metastatic disease. 11. Up to 5-6 years median observation
time there is no proof that the risk of second neoplasms is
increased by currently used adjuvant chemotherapy regimens.
12. More and highly critical prospective trials are needed to
assess not only effectiveness, but also patient tolerance
(cost-benefit ratio) of adjuvant therapies in breast cancer.
- Language of Publication
- English
- Unique Identifier
- 82259771
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- MeSH Heading (Major)
- Breast Neoplasms|DT/*TH
- MeSH Heading
- Antineoplastic Agents|AE/TU; Dose-Response Relationship,
Drug; Female; Hormones|TU; Human; Neoplasm Recurrence, Local
- Publication Type
- JOURNAL ARTICLE; REVIEW
- ISSN
- 0344-5704
- Country of Publication
- GERMANY, WEST
Record 33 from database: MEDLINE
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- Title
- A clinical trial in the management of operable cancer of the
breast.
- Author
- Langlands AO; Prescott RJ; Hamilton T
- Address
-
- Source
- Br J Surg, 1980 Mar, 67:3, 170-4
- Abstract
- The results of a randomized controlled clinical trial in the
management of operable breast cancer are given. Between 1964
and 1971 498 women, aged 35-69 years, were treated within the
trial protocol. Those under 60 years of age on entry underwent
ovarian ablation, usually by surgery, and were allocated
randomly to treatment by either radical mastectomy (RM) or
simple mastectomy and postoperative radiotherapy (SM).
Follow-up data for the first 12 years are presented and show
that survival in the radical mastectomy group is significantly
better (P less than 0.05), particularly in clinical stage 1
disease. The pattern of survival once recurrence was detected
also showed interesting differences between the two treatment
groups. Overall there was a significantly prolonged survival
after detection of recurrence in the RM group (P less than
0.05) which was most marked when local recurrence and distant
metastases coincided (P less than 0.01). The duration of
survival once recurrence had taken place was independent of
tumour size, clinical stage of the disease or menstrual status
at the time of presentation, but was directly proportional to
the duration of the disease-free inerval (P less than 0.01).
- Language of Publication
- English
- Unique Identifier
- 80154401
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- MeSH Heading (Major)
- Breast Neoplasms|MO/RT/*SU
- MeSH Heading
- Adult; Aged; Castration; Clinical Trials; Comparative Study;
Female; Follow-Up Studies; Human; Mastectomy|MT; Menopause;
Menstruation; Middle Age; Neoplasm Metastasis; Neoplasm
Recurrence, Local|MO; Random Allocation
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0007-1323
- Country of Publication
- ENGLAND
Record 34 from database: MEDLINE
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- Title
- The correlation between the spread of metastases by level in
the axillary nodes and disease-free survival in breast cancer.
A multifactorial analysis.
- Author
- Gaglia P; Bussone R; Caldarola B; Lai M; Jayme A; Caldarola
L
- Address
- Istituto di Oncologia, Cattedra di Oncologia Chirurgica
dell'UniversitÄa di Torino, Italy.
- Source
- Eur J Cancer Clin Oncol, 1987 Jun, 23:6, 849-54
- Abstract
- Axillary lymph nodes were separated from 492 radical or
modified radical mastectomies for primary breast cancer and
examined according to their anatomical level corresponding to
their position along the theoretical pathway of lymph drainage
from the breast. The patterns of metastasis and the
relationship between metastatized levels and disease-free
survival were investigated to see whether complete axillary
dissection is necessary for the staging and the planning of
adjuvant therapy in breast cancer. Progressive involvement
from level I (proximal) to level III (distal) was found in 206
specimens (80.8% of tumors with axillary metastases), while
discontinuous or "skip" metastases were present in
49 (19.2%), including 38 (14.9%) with positive nodes at level
II or III but not at level I. "Skip" metastasis was
more frequent when fewer than four nodes were positive, and
not related to either the size of the primary tumor or its
location. The effect of age, menopausal status, tumor size,
node status, number of positive nodes, anatomic level of
axillary node involvement, estrogen and progesterone
receptors, and adjuvant therapies on disease-free survival was
evaluated using a multivariate proportional hazard model and
life table analysis. This showed that disease-free survival
was strongly related to the number of positive nodes (P less
than 0.001), tumor size (P = 0.001) and level of node
involvement (P = 0.01) as independent prognostic factors.
Moreover, the subset of patients with four or more positive
nodes and involvements of level III had a higher risk of
recurrence (25% recurrence-free patients 5 years after
mastectomy). The high frequency of "skip" metastases
and the prognostic value of both the level of involvement and
the number of metastatic nodes suggest that a complete
axillary dissection is needed in the surgical management of
breast cancer to obtain all the data useful in the planning of
adjuvant therapy.
- Language of Publication
- English
- Unique Identifier
- 88004655
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- MeSH Heading (Major)
- Breast Neoplasms|MO/*PA/TH; Lymph Nodes|*PA
- MeSH Heading
- Axilla; Female; Follow-Up Studies; Human; Lymphatic
Metastasis; Mastectomy; Neoplasm Recurrence, Local; Prognosis;
Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0277-5379
- Country of Publication
- ENGLAND
Record 35 from database: MEDLINE
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- Title
- Combined adjuvant therapy of radically operated colorectal
cancer patients. (chemotherapy, radiotherapy, and MER-BCG).
- Author
- Robinson E; Bartal A; Cohen Y; Haim N; Mohilever J; Mekori T
- Address
-
- Source
- Cancer Chemother Pharmacol, 1982, 8:1, 35-40
- Abstract
- Seventy-three patients with Dukes' B2 and C colorectal
cancer were randomized to adjuvant therapy after radical
surgery. One group was treated with chemotherapy either alone
or in combination with radiotherapy (RC). The second group was
treated by chemotherapy (with or without radiotherapy) plus
MER/BCG (RCM). In patients with Dukes' C disease, the survival
at 54 months and the disease-free interval up to 24 months
were significantly better in the RCM than in the RC subgroup.
There were no significant differences in the survival and
disease-free interval between RC- and RCM-treated patients
with Dukes' B2 disease. Entry of additional patients and
further follow-up are needed before we can decide whether the
combination of RCM increases the cure rate in Dukes' C cancer
or merely delays recurrence and prolongs survival.
- Language of Publication
- English
- Unique Identifier
- 82234009
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- MeSH Heading (Major)
- BCG Vaccine|*TU; Colonic Neoplasms|RT/*TH; Rectal
Neoplasms|RT/*TH
- MeSH Heading
- Adult; Aged; Female; Fluorouracil|TU; Human; Immunotherapy;
Male; Middle Age; Neoplasm Recurrence, Local; Support,
Non-U.S. Gov't
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0344-5704
- Country of Publication
- GERMANY, WEST
Record 36 from database: MEDLINE
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- Title
- Chemotherapy before and after mastectomy in stage III breast
cancer.
- Author
- Perloff M; Lesnick GJ
- Address
-
- Source
- Arch Surg, 1982 Jul, 117:7, 879-81
- Abstract
- Seventeen patients with stage III breast cancer were treated
by modified radical mastectomy preceded and followed by
multiagent cytotoxic chemotherapy. The preoperative treatment
resulted in a decrease in size of the primary tumor,
facilitating the subsequent surgical procedure. There were no
serious surgical complications. Wound healing was uneventful.
Median disease-free survival time was 29 months and median
survival time was 40+ months. Six of the 17 patients are
living free of recurrence from more than 33 to more than 79
months after initial therapy.
- Language of Publication
- English
- Unique Identifier
- 82230490
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- MeSH Heading (Major)
- Antineoplastic Agents|*AD; Breast Neoplasms|DT/MO/PA/*SU;
Mastectomy|*
- MeSH Heading
- Adult; Aged; BCG Vaccine|TU; Comparative Study; Drug
Therapy, Combination; Female; Human; Menopause; Middle Age;
Neoplasm Staging; Postoperative Care; Preoperative Care; Time
Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0004-0010
- Country of Publication
- UNITED STATES
Record 37 from database: MEDLINE
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- Title
- Recurrent cancer of the cervix following radical
hysterectomy and pelvic node dissection.
- Author
- Krebs HB; Helmkamp BF; Sevin BU; Poliakoff SR; Nadji M;
Averette HE
- Address
-
- Source
- Obstet Gynecol, 1982 Apr, 59:4, 422-7
- Abstract
- Forty patients with recurrence following radical surgery for
early invasive cancer of the cervix were studied. Fifty-eight
percent of the recurrences were observed within the first 12
months after surgery and 83% within the first 2 years. The
site of recurrence was found to influence diagnosis,
symptomatology, clinical findings, prognosis, cause of death,
and therapy. The prognosis for patients with recurrent
cervical cancer was poor, with only 5 patients (13%) surviving
free of disease after 5 years. One patient is presently alive
and without disease for more than 2 years. Patients who did
not receive a potentially curative course of radiation therapy
at the time of diagnosis of the recurrence had a poor
prognosis. None of the patients managed by exenterative
procedures or chemotherapy survived. Guidelines are suggested
for follow-up after primary radical hysterectomy and pelvic
node dissection.
- Language of Publication
- English
- Unique Identifier
- 82196304
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- MeSH Heading (Major)
- Cervix Neoplasms|MO/RT/*SU; Hysterectomy|*; Lymph Node
Excision|*
- MeSH Heading
- Female; Human; Neoplasm Recurrence, Local
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0029-7844
- Country of Publication
- UNITED STATES
Record 38 from database: MEDLINE
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- Title
- Radiation therapy with or without primary limited surgery
for operable breast cancer: a 20-year experience at the
Marseilles Cancer Institute.
- Author
- Amalric R; Santamaria F; Robert F; Seigle J; Altschuler C;
Kurtz JM; Spitalier JM; Brandone H; Ayme Y; Pollet JF;
Burmeister R; Abed R
- Address
-
- Source
- Cancer, 1982 Jan, 49:1, 30-4
- Abstract
- Since 1960 more than 3000 consecutive patients with operable
infiltrating breast carcinoma were treated by radiation
therapy with or without primary limited surgery, which usually
consisted of local excision. For tumors smaller than or equal
to 5 cm the ten-year crude survival rate is 77% for patients
without palpable axillary nodes (T1-2N0) and 63% for patients
having axillary adenopathy (T1-2N0). For operable tumors
exceeding 5 cm of diameter (T3N0-1) the ten-year crude
survival is 34%. Thirty-five percent of the patients alive
free of disease at ten years required a secondary operation
for presumed local or regional tumor persistence or
recurrence, although no residual disease was found in 24% of
the operative specimens. Local-regional recurrence had no
adverse effect on ten-year survival. This conservative
approach offers most women with operable breast cancer an
excellent chance at breast preservation with the same chance
for ten-year survival as with radical mastectomy.
- Language of Publication
- English
- Unique Identifier
- 82093071
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- MeSH Heading (Major)
- Breast Neoplasms|PA/*RT/SU
- MeSH Heading
- Axilla; Comparative Study; Female; Follow-Up Studies;
France; Human; Lymph Nodes|PA; Mastectomy; Neoplasm
Recurrence, Local|SU; Neoplasm Staging; Prognosis; Time
Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 39 from database: MEDLINE
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- Title
- Principles of surgical management of breast cancer.
- Author
- Scanlon EF
- Address
-
- Source
- Isr J Med Sci, 1981 Sep, 17:9-10, 936-9
- Abstract
- Until recently surgical ablation was the primary treatment
of choice for operable breast cancers. Increasingly, this
position has been challenged by concepts of lesser surgical
procedures coupled with radiotherapy. The trend of recurrence
rates suggests that wide local excision of the primary tumor
followed by irradiation may give as good results as more
extensive surgical procedures. Long-term evaluation of
morbidity, treatment time, and costs, must also be included in
these comparisons. One of the more attractive features of
these lesser procedures is the improved cosmetic result. Good
cosmetic results after modified radical mastectomy require a
greater appreciation of the importance of the anterior
thoracic nerves to prevent atrophy of the pectoral muscles.
Adjuvant therapy after mastectomy needs to be evaluated in
greater detail. Radiotherapy prevents local recurrence but
does not affect the tumor-free interval or survival rates.
Adjuvant chemotherapy prolongs the tumor-free interval but its
effect on survival rates is not yet known.
- Language of Publication
- English
- Unique Identifier
- 82075250
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- MeSH Heading (Major)
- Breast Neoplasms|RH/*SU/TH; Mastectomy|*MT
- MeSH Heading
- Drug Therapy, Combination; Female; Human; Prognosis;
Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0021-2180
- Country of Publication
- ISRAEL
Record 40 from database: MEDLINE
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- Title
- Radical versus modified radical mastectomy for breast
cancer.
- Author
- Turner L; Swindell R; Bell WG; Hartley RC; Tasker JH;
Wilson WW; Alderson MR; Leck IM
- Address
-
- Source
- Ann R Coll Surg Engl, 1981 Jul, 63:4, 239-43
- Abstract
- A prospective randomised trial (534 patients, 1969-75) was
designed to determine whether radical mastectomy conferred
advantages over modified radical mastectomy for breast
cancer in terms of total survival, local recurrence, distant
metastasis, and disease-free interval. The results showed no
significant difference in outcome as regards these variables
between the two treatments.
- Language of Publication
- English
- Unique Identifier
- 81230827
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- MeSH Heading (Major)
- Breast Neoplasms|MO/*SU; Mastectomy|*MT
- MeSH Heading
- Female; Human; Neoplasm Metastasis; Neoplasm Recurrence,
Local; Prospective Studies; Random Allocation
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED
TRIAL
- ISSN
- 0035-8843
- Country of Publication
- ENGLAND
Record 41 from database: MEDLINE
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- Title
- Identification of breast cancer patients with high risk of
early recurrence after radical mastectomy: III. Steroid
hormones measured in urine.
- Author
- Segaloff A; Hankey BF; Carter AC; Bundy B; Masnyk IJ
- Address
-
- Source
- Cancer, 1980 Sep, 46:5, 1087-92
- Abstract
- The relationship of the levels of selected urinary steroid
metabolites to breast cancer recurrence after radical
mastectomy was studied. An analysis of variance of the
steroid measurements suggested that the measurements
standardized to per gram of creatinine were the appropriate
measure to use in exploring these relationships. No
significant associations were found for premenopausal
patients; however, for postmenopausal patients, low levels
of total 17-ketosteroids were associated with a reduced
two-year recurrence-free rate whereas low and high levels of
OHA and high levels of total estrogens were associated a
relatively low high two-year recurrence-free rate. Because
of the large number of significance tests performed and the
lack of consistent patterns, it is questionable whether the
observed associations are of any importance. Including these
steroid quantities in a multivariate regression model along
with previously determined clinical prognostic factors
indicated that the steroid determinations were the least
important variables and did not make a significant
contribution to the fit of the model.
- Language of Publication
- English
- Unique Identifier
- 81162270
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- MeSH Heading (Major)
- Breast Neoplasms|SU/*UR; Hormones|*UR; Neoplasm
Recurrence, Local|*
- MeSH Heading
- Analysis of Variance; Androsterone|UR; Comparative Study;
Estrogens|UR; Female; Human; Mastectomy; Menopause; Middle
Age; Risk; Support, U.S. Gov't, P.H.S.; 17-Ketosteroids|UR
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 42 from database: MEDLINE
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- Title
- Prostate cancer screening in Tyrol, Austria: experience
and results.
- Author
- Horninger W; Reissigl A; Rogatsch H; Volgger H; Studen M;
Klocker H; Bartsch G
- Address
- Department of Urology, University of Innsbruck, Austria.
wolfgang.horninger@uibk.ac.at
- Source
- Eur Urol, 1999, 35:5-6, 523-38
- Abstract
- BACKGROUND: This article summarizes the experience and
results of different prostate carcinoma screening projects
using total prostate-specific antigen (PSA) and percent free
PSA as the initial test. METHODS: The twelve projects
studied included: (1) a mass screening study using PSA as
the initial test in 21,079 volunteers; (2) an investigation
of the usefulness of normal and age-referenced PSA cut-offs
in 1,618 men; (3) a PSA-based screening study of 2,272
asymptomatic blood donors; (4) an investigation of the
evidence and significance of transition zone carcinoma in
340 men with negative digital rectal examination findings;
(5) determination of percent free PSA in one retrospective
and two prospective studies to determine the appropriate
cutpoints for percent free PSA; (6) evaluation of the
diagnostic benefit of PSA transition zone density in 308
screening volunteers; (7) a study of the impact of PSA-based
screening on the percentage of incidental prostate carcinoma
in 1, 543 men undergoing transurethral resection of the
prostate; (8) an evaluation of the changes in total PSA and
pathologic stages in radical prostatectomy over 5 years in a
PSA-based mass screening program; (9) a study evaluating the
probability of having prostate cancer given the patient's
age, total PSA and digital rectal examination findings; (10)
an evaluation of the correlation between preoperative
predictors and pathologic features in radical prostatectomy
specimens; (11) an investigation of the correlation of total
PSA with pathologic stage and tumor volume in patients
undergoing radical prostatectomy with low PSA cut-off level,
and (12) a study whether age has an impact on the extension
of prostate cancer. RESULTS: (1) of the 21,079 volunteers,
1,618 (8%) had elevated PSA levels. Of these men, 778 (48%)
underwent biopsies; 197 biopsies were positive for prostate
carcinoma and 135 underwent radical prostatectomy.
Ninety-five were found to be organ-confined. (2) A PSA
cut-off of 2.5 ng/ml in men aged 45-49 years and of 3.5 ng/ml
in men aged 50-59 years resulted in an 8% increase in the
detection rate of organ-confined disease. (3) Of the 2,272
men, 284 had elevated PSA levels and prostate carcinoma was
detected in 62 men. All patients underwent radical
prostatectomy and histologic examination revealed
organ-confined tumor in all but 8 men. (4) Ninety-eight of
340 men had biopsies positive for carcinoma; 28 of these
patients (28.5%) had carcinoma that originated in the
transition zone only. (5) In the retrospective study,
receiver-operating characteristic curve analysis showed that
by using a percent free PSA of 18% as a biopsy criterion,
37% of the negative biopsies could be eliminated although
94% of all carcinomas would still be detected. In the first
prospective study, 106 of 158 men with elevated PSA levels
<10.0 ng/ml were further evaluated and 37 prostate
carcinomas were detected. By using a % free PSA of <22%
as a biopsy criterion, 30% of the negative biopsies could be
eliminated although 98% of the carcinomas would still be
detected. In the second prospective study, 120 of 465 men
with total PSA levels between 1.25 and 6.49 ng/ml and a %
free PSA <18% were further evaluated and 27 (22.5%) were
found to have prostate carcinomas. (6) Receiver-operating
characteristic curve analysis for PSA transition zone
density showed that by using a PSA transition zone density
of >22 ng/ml/cm3 as a biopsy criterion, 24.4% of negative
biopsies could be avoided without missing a single
carcinoma. (7) In the prescreening era the incidence of T1a
grade 1 and 2 carcinomas was 3.1% and the incidence of T1a
grade 3 and T1b carcinoma was 2.3% whereas in the years
after the establishment of PSA-based screening the incidence
was 4.6 and 1.03% respectively. (8) The rate of
organ-confined tumors increased from 28.7% in 1993 to 65.7%
in 1997. (9) In this evaluation a new approach to proceed
with a prostate biopsy based upon the individual risk of
having prostate cancer rath
- Language of Publication
- English
- Unique Identifier
- 99262459
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- MeSH Heading (Major)
- Mass Screening|*OG; Prostate-Specific Antigen|*AN;
Prostatic Neoplasms|*DI/EP/PA
- MeSH Heading
- Adult; Age Distribution; Aged; Austria|EP; Biopsy, Needle;
Comparative Study; Human; Incidence; Male; Middle Age;
Neoplasm Staging; Risk Factors; Sensitivity and Specificity
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0302-2838
- Country of Publication
- SWITZERLAND
Record 43 from database: MEDLINE
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- Title
- Two-year survival: preoperative adjuvant chemotherapy in
the treatment of cervical cancer stages Ib and II with bulky
tumor.
- Author
- Kim DS; Moon H; Kim KT; Hwang YY; Cho SH; Kim SR
- Address
- Department of Obstetrics and Gynecology, School of
Medicine, Hanyang University, Seoul, Korea.
- Source
- Gynecol Oncol, 1989 May, 33:2, 225-30
- Abstract
- The effect of preoperative adjuvant chemotherapy on the
2-year survival rate of patients with locally advanced
cervical cancer (stages Ib and II with bulky tumour) was
evaluated. The 54 patients first received initial
chemotherapy of vinblastine, bleomycin, and cis-platinum in
a combined regimen (VBP) and then radical hysterectomy. The
overall histologic response rate to chemotherapy of the
primary tumor confirmed in the surgical specimen was 81%
including microscopic or no evidence of disease (41%, Grade
III or IV). A lower than expected incidence of lymph node
metastasis (20%) was found. All nodal metastasis was noted
in patients with Grades I or II (P = 0.0034). Median
follow-up was 36 months (range 26-60 months). Three
recurrences (6%) appeared and those patients died of the
disease within 24 months. Thus the 2-year tumour-free
survival rate was 94%. The patients who had positive nodes
more often experienced recurrence (27 vs 0%) and a lower
2-year survival rate (72 vs 100%) (P = 0.0067). All of these
recurrences were found in patients with three or more
positive nodes. This preliminary study suggest that
preoperative adjuvant chemotherapy (VBP) is effective (1) in
reducing tumour volume or the stage of the disease, (2) in
curing the lymph node involvement, and (3) in improving the
2-year tumour-free survival rate. A prospective randomized
study comparing radical surgery alone with preoperative
adjuvant chemotherapy followed by radical surgery is in
progress.
- Language of Publication
- English
- Unique Identifier
- 89197034
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- MeSH Heading (Major)
- Antineoplastic Agents, Combined|*TU; Carcinoma, Squamous
Cell|MO/PA/*TH; Cervix Neoplasms|MO/PA/*TH; Preoperative
Care|*
- MeSH Heading
- Adult; Bleomycin|AD; Cisplatin|AD; Combined Modality
Therapy; Female; Follow-Up Studies; Human; Hysterectomy;
Lymph Node Excision; Lymphatic Metastasis; Middle Age;
Neoplasm Metastasis; Neoplasm Staging; Vinblastine|AD
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0090-8258
- Country of Publication
- UNITED STATES
Record 44 from database: MEDLINE
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- Title
- Management of stage A prostate cancer with a high
probability of progression [see comments]
- Author
- Lowe BA; Listrom MB
- Address
- Department of Surgery, University of New Mexico School of
Medicine, Albuquerque.
- Source
- J Urol, 1988 Dec, 140:6, 1345-7
- Abstract
- For the patient with incidentally discovered prostatic
cancer that has a high probability of progression further
treatment may be indicated. Several studies have shown that
survival free of disease is increased by additional therapy
but the choice of treatment remains unclear. The lack of
matched controls has prevented rigid statistical analysis of
the efficacy of prostatectomy and radiotherapy or expectant
management in the treatment of these tumors. A prior review
of 251 patients with stage A prostate cancer provided a
population base from which to perform a matched pair
analysis between 30 control patients receiving no additional
treatment and 30 patients treated by either prostatectomy or
radiotherapy. A second and unpaired analysis was performed
among patients undergoing radical prostatectomy (17),
radiotherapy (31) and expectant management alone (33). The
treated group achieved a significantly superior survival
free of disease over the matched control group managed
expectantly. The unpaired analysis again demonstrated the
advantages of treatment over no treatment but failed to
define a clear statistical difference between the 2 treated
groups. Radical prostatectomy appeared to provide a
recognizable advantage over radiotherapy in survival free of
disease but was not statistically significant owing to the
small size of the sample population.
- Language of Publication
- English
- Unique Identifier
- 89055852
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- MeSH Heading (Major)
- Prostatic Neoplasms|RT/*SU
- MeSH Heading
- Aged; Brachytherapy; Combined Modality Therapy; Follow-Up
Studies; Human; Male; Middle Age; Postoperative
Complications|ET; Prognosis; Prostatectomy; Urinary
Incontinence|ET
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0022-5347
- Country of Publication
- UNITED STATES
Record 45 from database: MEDLINE
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- Title
- Long-term results of radical prostatectomy in clinically
localized prostate cancer: experience at the Johns Hopkins
Hospital.
- Author
- Lepor H; Walsh PC
- Address
- Department of Urology, Johns Hopkins Medical Institutions,
Baltimore, MD.
- Source
- NCI Monogr, 1988, :7, 117-22
- Abstract
- The objectives of our retrospective long-term analysis of
radical prostatectomy at The Johns Hopkins Hospital are to
determine the efficacy of radical prostatectomy and the
optimal statistical method for ascertaining survival
following therapeutic intervention for men with clinically
localized prostate cancer. The duration of survival and the
cause of death were ascertained for 57 men with clinical
stage B1 prostate cancer who had radical prostatectomies at
The Johns Hopkins Hospital between 1951 and 1963. The
absence of metastatic disease was determined by radiographic
survey of the bones only. The survival curve determined by
the direct method was virtually identical to the projected
survival curve for a 62-year-old man in 1960. The
cause-specific actuarial survival analysis indicated that
only 14% of the men with stage B1 disease and a 15-year life
expectancy will develop metastatic prostate cancer following
radical prostatectomy. The cause-specific survival curve
plateaued after 10 years, which indicated that the majority
of men surviving 10 years free of disease are cured of the
disease. Survival analysis was also determined by the direct
method for 48 men with clinical stage B2 prostate cancer who
had undergone radical prostatectomy between 1951 and 1963.
Overall, the survival rates for these men were considerably
lower than those for similarly treated men with clinical
stage B1 disease. The survival curves following radical
prostatectomy for men with stage B1 disease and clinical
stage B2 disease pathologically confined to the prostate
were similar. Radical prostatectomy for stage B1 disease was
performed with minimal morbidity, and potency was preserved
in most patients with the use of nerve-sparing
modifications.(ABSTRACT TRUNCATED AT 250 WORDS)
- Language of Publication
- English
- Unique Identifier
- 89014752
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- MeSH Heading (Major)
- Prostatectomy|*; Prostatic Neoplasms|MO/*SU
- MeSH Heading
- Human; Male; Neoplasm Recurrence, Local; Neoplasm Staging;
Postoperative Complications
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0893-2751
- Country of Publication
- UNITED STATES
Record 46 from database: MEDLINE
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- Title
- Inflammatory breast cancer. Determination of prognostic
factors by univariate and multivariate analysis.
- Author
- Chevallier B; Asselain B; Kunlin A; Veyret C; Bastit P;
Graic Y
- Address
-
- Source
- Cancer, 1987 Aug, 60:4, 897-902
- Abstract
- Between January 1977 and June 1983, 64 consecutive
patients were treated for unilateral inflammatory
nonmetastatic breast cancer. Our protocol included three or
four courses of induction chemotherapy, then locoregional
irradiation therapy with Co-60, followed by maintenance
chemotherapy only if induction chemotherapy had proven
effective. Eight patients with a residual tumor after
radiotherapy underwent a modified radical mastectomy.
Actuarial 3-year overall survival for the whole group was
38%, and the median disease-free survival time was 19
months. The effect of 17 factors on overall survival or
disease-free survival was analyzed. With univariate
analysis, eight factors were found to affect overall
survival or disease-free survival: extent of initial
erythema, size of initial edema, lymph node involvement,
erythema present at the end of initial chemotherapy,
erythema present at the end of radiotherapy, tumor size at
the end of induction chemotherapy, residual breast tumor at
the end of maintenance chemotherapy, and performance of a
radical mastectomy. Age at diagnosis, menopausal status,
type of chemotherapy, and date of appearance of inflammatory
signs did not influence prognosis. Multivariate analysis
using the Cox proportional hazard model isolated three bad
prognosis factors: erythema involving the whole breast at
initial diagnosis, erythema present at the end of initial
chemotherapy, and lymph node involvement.
- Language of Publication
- English
- Unique Identifier
- 87243964
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- MeSH Heading (Major)
- Breast Neoplasms|MO/RT/*TH
- MeSH Heading
- Actuarial Analysis; Adult; Aged; Antineoplastic Agents,
Combined|TU; Combined Modality Therapy; Female; Human;
Inflammation|TH; Lymphatic Metastasis; Middle Age;
Prognosis; Regression Analysis; Remission Induction
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 47 from database: MEDLINE
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- Title
- Cancer chemoprevention by supplemental carotenoids in
animals and humans.
- Author
- Santamaria L; Bianchi A
- Address
- Camillo Golgi Institute of General Pathology, Centro
Tumori, Pavia, Italy.
- Source
- Prev Med, 1989 Sep, 18:5, 603-23
- Abstract
- Experiments were carried out in mice demonstrating that
dietary carotenoids (beta-carotene or canthaxanthin),
starting before cancer initiation and continuing throughout
the experiment, have a protective effect against indirect
skin carcinogenesis induced by benzo[a]pyrene +/- UVA and
breast cancer induced by 8-methoxypsoralen + UVA.
Experiments in rats demonstrated that carotenoids also
prevent the direct gastric carcinogenesis induced by
N-methyl-N'-nitro-nitroso-guanidine. Recently, prevention by
beta-carotene against colon cancer induced in mice by
dimethylhydrazine, another indirect carcinogen, was
confirmed by others. The prospects for carotenoid
intervention with humans were based on their antitumorigenic
effect, which is quite independent of pro-vitamin A
activity, their lack of toxicity even after prolonged
administration, and their immunostimulating activity. These
facts helped to build up a rationale predicting that any
epithelial cancer, after radical surgery, can be
chemoprevented with supplemental carotenoids. Thus, it is
expected that the remaining initiated epithelial tissue will
be protected by quenching oxygen radical formation, against
the onset of a second primary malignancy. This type of
prevention can be envisaged in organs like the lung, urinary
bladder, breast, stomach, and colon-rectum. At present,
human intervention protocols with a randomized drug/placebo
method are underway under the supervision of the Centro
Tumori of Pavia to chemoprevent with beta-carotene second
primary lung or bladder cancer after radical surgery.
Preliminary observations regarding findings in humans
without randomization (1980-1988) in Pavia are also reported
here. This consisted of chemoprevention with beta-carotene
plus canthaxanthin against recurrence of different
epithelial malignancies after radical treatment (surgery +/-
chemoradiotherapy). None of the 11 cases recruited, on the
basis of radical nature of treatment and patient adherence,
have shown any recurrence beyond their expected disease-free
intervals.
- Language of Publication
- English
- Unique Identifier
- 90138807
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- MeSH Heading (Major)
- Carotenoids|AD/PD/*TU; Neoplasms|DH/PA/*PC; Neoplasms,
Experimental|DH/PA/*PC
- MeSH Heading
- Animal; Hamsters; Human; Mice; Rats; Support, Non-U.S.
Gov't
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
- ISSN
- 0091-7435
- Country of Publication
- UNITED STATES
Record 48 from database: MEDLINE
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- Title
- Sacral chordoma: 40-year experience at a major cancer
center.
- Author
- York JE; Kaczaraj A; Abi Said D; Fuller GN; Skibber JM;
Janjan NA; Gokaslan ZL
- Address
- Department of Neurosurgery, The University of Texas M.D.
Anderson Cancer Center, Houston 77030, USA.
- Source
- Neurosurgery, 1999 Jan, 44:1, 74-9; discussion 79-80
- Abstract
- OBJECTIVE: Sacral chordomas are relatively rare, locally
invasive, malignant neoplasms. Despite surgical resection,
adjuvant radiation therapy, and chemotherapy, recurrence
is common. This study reviews our experience during the
last 40 years at The University of Texas M.D. Anderson
Cancer Center, to determine the effects of various
treatment methods on the overall course of this disease
process. METHODS: A retrospective study was performed.
From 1954 to 1994, 27 patients with sacral chordomas were
evaluated at our institution. RESULTS: There were 19 male
and 8 female patients, with a mean age of 56 years (range,
27-80 yr). All except one of the patients presented with
pain, and 17 of 27 showed evidence of autonomic
dysfunction at initial presentation. Based on microscopic
examination of surgical specimen margins, surgical
procedures were categorized as either radical resection or
subtotal excision. All patients underwent at least one
surgical procedure, for a total of 67 procedures (28
radical resections and 39 subtotal excisions). Twelve
patients underwent one operation, whereas nine underwent
two procedures and six underwent more than two operations
(range, 3-16 operations). Radiation therapy was used in
conjunction with 13 of the 67 surgical procedures. The
median Kaplan-Meier estimate of the overall survival time
for the entire group was 7.38 years (range, 4 mo to 34
yr). Tumors recurred after 47 of the 67 procedures. The
overall disease-free interval for patients undergoing
radical resection was 2.27 years for each procedure,
compared with 8 months for each procedure for patients
treated with subtotal excision (log-rank test for the
inequality between the two curves, 19.58; P<0.0001).
The addition of radiation therapy prolonged the
disease-free interval for patients undergoing subtotal
resection (2.12 yr versus 8 mo; log-rank test for the
inequality between the two curves, 5.82; P<0.02).
CONCLUSION: Our results suggest frequent recurrences in
the majority of patients with chordomas. Radical resection
is associated with a significantly longer disease-free
interval, compared with subtotal removal of the tumor.
Addition of radiation after subtotal resection improves
the disease-free interval, although radiation therapy can
generally be used only once. Based on these findings, we
think that, whenever possible, radical resection should be
the treatment of choice for sacral chordomas.
- Language of Publication
- English
- Unique Identifier
- 99110257
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- MeSH Heading (Major)
- Chordoma|MO/PA/*TH; Sacrum|*/PA; Spinal Neoplasms|MO/PA/*SU
- MeSH Heading
- Adult; Aged; Case Report; Cause of Death; Combined
Modality Therapy; Disease-Free Survival; Female; Human;
Male; Middle Age; Oncology Service, Hospital; Texas;
Treatment Outcome
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0148-396X
- Country of Publication
- UNITED STATES
Record 49 from database: MEDLINE
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- Title
- Dose and dose intensity as determinants of outcome in
the adjuvant treatment of breast cancer. The Cancer and
Leukemia Group B [see comments]
- Author
- Budman DR; Berry DA; Cirrincione CT; Henderson IC; Wood
WC; Weiss RB; Ferree CR; Muss HB; Green MR; Norton L; Frei
E 3rd
- Address
- Department of Medicine, North Shore University
Hospital-New York University School of Medicine, Manhasset
11030, USA. budman@nshs.edu
- Source
- J Natl Cancer Inst, 1998 Aug, 90:16, 1205-11
- Abstract
- BACKGROUND: Both total dose and dose intensity of
adjuvant chemotherapy are postulated to be important
variables in the outcome for patients with operable breast
cancer. The Cancer and Leukemia Group B study 8541
examined the effects of adjuvant treatment using
conventional-range dose and dose intensity in female
patients with stage II (axillary lymph node-positive)
breast cancer. METHODS: Within 6 weeks of surgery (radical
mastectomy, modified radical mastectomy, or lumpectomy),
1550 patients with unilateral breast cancer were randomly
assigned to one of three treatment arms: high-, moderate-,
or low-dose intensity. The patients received
cyclophosphamide, doxorubicin, and 5-fluorouracil on day 1
of each chemotherapy cycle, with 5-fluorouracil
administration repeated on day 8. The high-dose arm had
twice the dose intensity and twice the drug dose as the
low-dose arm. The moderate-dose arm had two thirds the
dose intensity as the high-dose arm but the same total
drug dose. Disease-free survival and overall survival were
primary end points of the study. RESULTS: At a median
follow-up of 9 years, disease-free survival and overall
survival for patients on the moderate- and high-dose arms
are superior to the corresponding survival measures for
patients on the low-dose arm (two-sided P<.0001 and
two-sided P = .004, respectively), with no difference in
disease-free or overall survival between the moderate- and
the high-dose arms. At 5 years, overall survival (average
+/- standard error) is 79% +/- 2% for patients on the
high-dose arm, 77% +/- 2% for the patients on the
moderate-dose arm, and 72% +/- 2% for patients on the
low-dose arm; disease-free survival is 66% +/- 2%, 61% +/-
2%, and 56% +/- 2%, respectively. CONCLUSION: Within the
conventional dose range for this chemotherapy regimen, a
higher dose is associated with better disease-free
survival and overall survival.
- Language of Publication
- English
- Unique Identifier
- 98383563
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- MeSH Heading (Major)
- Antineoplastic Agents, Combined|*TU; Breast Neoplasms|*DT/PA/SU
- MeSH Heading
- Chemotherapy, Adjuvant; Cyclophosphamide|AD;
Disease-Free Survival; Dose-Response Relationship, Drug;
Doxorubicin|AD; Drug Administration Schedule; Female;
Fluorouracil|AD; Follow-Up Studies; Human; Lymphatic
Metastasis; Middle Age; Support, U.S. Gov't, P.H.S.;
Treatment Outcome
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0027-8874
- Country of Publication
- UNITED STATES
Record 50 from database: MEDLINE
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- Title
- Epidemiological and biochemical support for a theory on
the cause and prevention of breast cancer.
- Author
- Murrell TG
- Address
- Department of Community Medicine, University of
Adelaide, South Australia.
- Source
- Med Hypotheses, 1991 Dec, 36:4, 389-96
- Abstract
- Damage to the breast epithelium by chemical carcinogens
as products of oxygen free radical release can lead to
fibroblast proliferation, hyperplasia of epithelium,
cellular atypia and breast cancer. Chemical carcinogens
may accumulate in breast fluid in the non-lactating breast
consequent to superoxide free radical production which
occurs via the adenosine triphosphate (ATP) hypoxanthine
pathway. This pathway is initiated by hypoxia of local
tissue. Under hypoxic conditions ATP is broken down to
form hypoxanthine. Hypoxanthine itself is broken down to
produce xanthine and then uric acid. This results in the
production of superoxide free radicals, the products of
which are carcinogenic. The development of localized
hypoxia, which is central to this hypothesis, is caused by
acinal gland distention from fluid secreted by raised
prolactin levels in the absence of oxytocin. Stimulation
of the nipple in a non-lactating breast may raise plasma
oxytocin and lower plasma prolactin levels. Contraction of
the myoepithelial cells of the breast under the influence
of oxytocin would relieve distention of the acinal glands
and thus reduce hypoxia and the generation of lipid
peroxidoses as products of free radical damage. The
epidemiology of breast fibrosis and cancer support the
notion that lack of nipple stimulation over time may be a
significant variable. A review of this literature linked
with current biochemical work on fibrosis and
carcinogenesis suggest that draining the breasts of the
products of superoxide free-radical release by the
encouragement of regular nipple erections may prevent such
breast disease.
- Language of Publication
- English
- Unique Identifier
- 92236464
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- MeSH Heading (Major)
- Breast Neoplasms|EP/*ET/PC
- MeSH Heading
- Breast|SE; Female; Free Radicals; Human; Lactation;
Models, Biological; Oxytocin|PH; Prolactin|PH;
Reproduction
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
- ISSN
- 0306-9877
- Country of Publication
- ENGLAND
Record 51 from database: MEDLINE
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- Title
- Mitomycin C adjuvant chemotherapy after Wertheim's
hysterectomy for stage IB cervical cancer.
- Author
- Sivanesaratnam V; Jayalakshmi P
- Address
- Department of Obstetrics and Gynaecology, Faculty of
Medicine, University of Malaya, Kuala Lumpur.
- Source
- Cancer, 1989 Aug, 64:4, 798-800
- Abstract
- Patients undergoing radical surgical treatment for Stage
IB and IIA cervical carcinoma are at high risk of
developing local recurrence and/or distant metastases when
one or more of the following factors are present: presence
of metastatic pelvic lymph nodes, a large primary growth,
full-thickness tumor invasion of the cervix, clinically
undetected parametrial extension, and lymphatic/vascular
channel permeation in the cervix by tumor cells. Carcinoma
of the cervix appears to be behaving like a systemic
disease. Therefore, systemic measures should be considered
in its therapy. The authors report the initial experience
with the use of mitomycin C as a single agent adjuvant in
16 patients with Stage IB carcinoma of the cervix who had
undergone Wertheim radical hysterectomy and were thought
to be in this high-risk group. Fourteen of the patients
are alive and free of disease after durations of follow-up
ranging from 16 to 38 months, the disease-free survival at
a median follow-up of 29 months being 87.5%. One patient
required discontinuation of adjuvant chemotherapy because
of severe marrow toxicity; however, in view of the
presence of a multiple risk factors, pelvic irradiation
was given instead. She died 13 months later from
disseminated disease. A second patient died 6 months later
from congestive cardiac failure.
- Language of Publication
- English
- Unique Identifier
- 89303746
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- MeSH Heading (Major)
- Adenocarcinoma|*DT/PA/SU; Carcinoma, Squamous
Cell|*DT/PA/SU; Cervix Neoplasms|*DT/PA/SU;
Hysterectomy|*; Mitomycins|AE/*TU
- MeSH Heading
- Combined Modality Therapy; Female; Follow-Up Studies;
Human; Lymphatic Metastasis; Risk Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 52 from database: MEDLINE
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- Title
- The role of oxygen-derived free radicals in the
cytotoxicity of doxorubicin in multidrug resistant and
sensitive human ovarian cancer cells.
- Author
- Cervantes A; Pinedo HM; Lankelma J; Schuurhuis GJ
- Address
- Department of Oncology, Free University Hospital,
Amsterdam, The Netherlands.
- Source
- Cancer Lett, 1988 Aug, 41:2, 169-77
- Abstract
- The role of oxygen-derived free radicals in the
cytotoxicity of doxorubicin (Dox) was studied in a Dox
sensitive human ovarian cancer cell line (A2780) and its
multidrug resistant counterpart (2780AD) using reactive
oxygen scavengers. In both cell lines, a significant
inhibition of Dox toxicity was found after treatment with
the hydroxyl radical scavengers, N-acetylcysteine, sodium
benzoate and dimethyl sulfoxide, but not with mannitol.
The protection was similar in sensitive and resistant
cells: 13-39% less growth inhibition was found at Dox
concentrations of 0.2 and 0.5 microM for A2780 as well as
at 20 and 50 microM for 2780AD. This protection was not
due to effects of the scavengers on Dox accumulation, as
shown by uptake experiments with radio-labelled Dox. The
superoxide anion free radical scavenger ascorbic acid or
the enzyme superoxide dismutase as well as the hydrogen
peroxide scavenger catalase did not protect cells against
Dox-induced cell growth inhibition. Preloading the cells
with the enzymes, a treatment which resulted in a two to
nine-fold increase in their cellular contents, was not
effective either. It is concluded that hydroxyl radicals,
but not superoxide anion or hydrogen peroxide likely play
a role in the antitumor activity of Dox in sensitive and
resistant human ovarian cancer cells.
- Language of Publication
- English
- Unique Identifier
- 88294969
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- MeSH Heading (Major)
- Doxorubicin|*PD; Oxygen|*ME; Tumor Cells,
Cultured|*DE/ME
- MeSH Heading
- Acetylcysteine|PD; Ascorbic Acid|PD; Benzoates|PD;
Catalase|PD; Cell Division|DE; Cell Survival|DE; Drug
Resistance; Female; Free Radicals; Human; Hydroxides|ME;
Kinetics; Mannitol|PD; Ovarian Neoplasms; Superoxide
Dismutase|PD; Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0304-3835
- Country of Publication
- NETHERLANDS
Record 53 from database: MEDLINE
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- Title
- Role of free radicals in an adriamycin-resistant human
small cell lung cancer cell line.
- Author
- Meijer C; Mulder NH; Timmer Bosscha H; Zijlstra JG; de
Vries EG
- Address
-
- Source
- Cancer Res, 1987 Sep, 47:17, 4613-7
- Abstract
- In two Adriamycin (Adr) resistant sublines (GLC4-Adr1
and GLC4-Adr2) of a human small cell lung carcinoma cell
line, GLC4, cross-resistance for radiation was found.
GLC4-Adr1 has an acquired Adr resistance factor of 44
after culturing without Adr for 20 days and GLC4-Adr2, the
same subline cultured without Adr for 3 months, has a
decreased but stable resistance factor of 8. One of the
assumed mechanisms of Adr is that the effect is mediated
through the formation of free radicals. Therefore free
radical scavenging might play a role in these Adr
resistant cell lines. Adr, H2O2, and X-ray induced
cytotoxicity were evaluated. Glutathione (GSH) levels and
activities of associated enzymes were determined as well
as Adr, H2O2, and X-ray induced DNA breaks and repair. GSH
level was decreased in GLC4-Adr1, but restored to the
normal level in GLC4-Adr2. Superoxide dismutase, catalase,
glutathione-peroxidase, and glutathione S-transferase were
not elevated in the resistant sublines. Adr induced a
decreased amount of DNA breaks in GLC4-Adr1 compared to
GLC4. For X-ray and H2O2 a comparable amount of DNA damage
was found. GLC4-Adr1 was able to repair DNA breaks induced
by Adr, X-ray, and H2O2 better than GLC4. In conclusion,
no increased enzyme capacity for detoxification of free
radicals could be detected in the cytosol of the resistant
cells. The resistance against free radicals in the
GLC4-Adr1 line may at least in part be a result of
increased DNA repair.
- Language of Publication
- English
- Unique Identifier
- 87301373
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- MeSH Heading (Major)
- Carcinoma, Small Cell|*DT; Doxorubicin|*PD; Lung
Neoplasms|*DT
- MeSH Heading
- Cell Line; Cell Survival; Drug Resistance; DNA Damage;
Free Radicals; Glutathione|AN; Glutathione Peroxidase|AN;
Human; Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-5472
- Country of Publication
- UNITED STATES
Record 54 from database: MEDLINE
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- Title
- Radical surgery for ethmoid cancer.
- Author
- Bridger GP
- Address
-
- Source
- Arch Otolaryngol, 1980 Oct, 106:10, 630-4
- Abstract
- Radical surgery followed by radiotherapy offers the best
chance of cure for ethmoid cancer. In operations on 15
patients with ethmoid cancer, intracranial spread was
found in five instances. In every patient, a craniofacial
ethmoidectomy was performed. Two approaches are
recommended. If there is radiologic or clinical evidence
of intracranial spread, a frontal craniotomy and lateral
rhinotomy approach is employed. With the help of the
neurosurgeon, the overlying dura can be resected with the
anterior cranial floor. When the cribriform plate appears
intact, the resection is accomplished via a lateral
rhinotomy and transfrontal sinus approach to the anterior
cranial fossa. These techniques were used in 15 patients.
Nine are free of recurrence after an observation time of
two to seven years.
- Language of Publication
- English
- Unique Identifier
- 81020761
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- MeSH Heading (Major)
- Adenocarcinoma|*SU; Ethmoid Sinus|*SU; Meningeal
Neoplasms|*SU; Paranasal Sinus Neoplasms|*SU
- MeSH Heading
- Adult; Carcinoma|SU; Carcinoma, Adenoid Cystic|SU;
Carcinoma, Squamous Cell|SU; Craniotomy|MT; Human;
Melanoma|SU; Middle Age; Neoplasm Invasiveness;
Neuroectodermal Tumors, Primitive, Peripheral|SU; Orbital
Neoplasms|SU; Surgery, Plastic|MT
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0003-9977
- Country of Publication
- UNITED STATES
Record 55 from database: MEDLINE
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- Title
- Dysdifferentiation hypothesis of aging and cancer: a
comparison with the membrane hypothesis of aging.
- Author
- Zs Nagy I; Cutler RG; Semsei I
- Address
- VerzÆar International Laboratory for Experimental
Gerontology, Research Department, Italian National
Research Centers on Aging (INRCA), Ancona.
- Source
- Ann N Y Acad Sci, 1988, 521:, 215-25
- Abstract
- Our laboratories have been testing the basic concept
that the age-dependent deterioration of the molecular
components of living systems may be due in part to the
biochemical effects of active oxygen species. The
dysdifferentiation hypothesis of aging and cancer (DHAC)
as well as the membrane hypothesis of aging (MHA) are
discussed and compared to each other. These two hypotheses
consider cellular mechanisms through which free
radical-induced alterations may lead to the aging process.
DHAC emphasizes the importance of the instability of the
differentiated state of cells and how active oxygen
species may interact with the genetic apparatus of cells,
leading to improper gene regulation. The evidence
supporting this hypothesis includes an age-dependent
increase in the expression of specific genes that normally
are expected to be repressed. Such evidence now includes
the c-myc oncogene as well as an age-dependent decrease in
the average methylation level of the entire genome in
liver tissue of mice. The central concept of DHAC is that
aging is a result of gene regulatory instability and that
lifespan is governed by mechanisms acting to stabilize
proper gene regulation. MHA is based on the concept that
all cellular components are exposed to free-radical
attacks, and that the damaging efficiency of the radicals
is density-dependent. Compact structures like membranes
are consequently more susceptible to damage than cytosolic
components. In addition, the cell plasma membrane is
exposed to another damaging effect called residual heat
damage, which is due to the depolarization-induced
discharge of the membrane during the action potential. MHA
predicts that a key process of normal differentiation as
well as aging is a continuous, age-dependent loss of the
passive permeability of the cell membrane for potassium
and probably also for water. This is due to a constant
difference between the rates of damage and replacement of
the membrane components and results in a gradual
dehydration of the intracellular mass from the embryonic
state to the aging state. The increasing intracellular
density will eventually become rate-limiting for many
different cellular functions, resulting in the cessation
of growth and the beginning of aging. MHA also predicts an
overall decrease of gene expression and protein turnover
rate during aging. Pharmacological interventions on the
cell membrane have supported the validity of MHA and have
indicated specific mechanisms of how aging and
dysdifferentiation may occur.
- Language of Publication
- English
- Unique Identifier
- 88239293
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- MeSH Heading (Major)
- Aging|ME/*PA; Cell Differentiation|*; Cell Membrane|*ME;
Models, Biological|*; Neoplasms|GE/ME/*PA
- MeSH Heading
- Body Water|ME; Cell Membrane Permeability; Comparative
Study; Free Radicals; Gene Expression Regulation; Human;
Oncogenes; Oxygen|ME
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
- ISSN
- 0077-8923
- Country of Publication
- UNITED STATES
Record 56 from database: MEDLINE
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- Title
- The avoidance of small intestine injury in gynecologic
cancer.
- Author
- Green N
- Address
-
- Source
- Int J Radiat Oncol Biol Phys, 1983 Sep, 9:9, 1385-90
- Abstract
- The evolution of systematized operative staging and
radical surgical procedures in the management of
gynecologic cancer has increased the complexities of
integrating radiation therapy. High dose irradiation to
large treatment volumes has been associated with an
increased incidence of small intestine injury. This
complication is morbid and often fatal. Although
predisposing factors have been extensively studied,
there has been a paucity of reports evaluating
preventative measures. Between 1975 and 1980, 140
patients with gynecologic cancer were treated at the
Valley Presbyterian Hospital in the Division of
Radiation Therapy. Twenty-six patients with cervix
cancer received definitive irradiation and seven
received adjunct irradiation. Seventy-two with corpus
cancer received adjunct irradiation, seven received
definitive irradiation and three palliative irradiation.
Eleven patients with ovarian cancer received adjunct
irradiation and 15 palliative irradiation. Eight-five
patients were at potential risk for small intestine
injury and had treatment planning small intestine X
rays. Fixation was observed in 7/39 (18%) without prior
pelvic surgery and 30/46 (65%) with prior pelvic
surgery. Information from the small intestine X rays
were used in 41 patients to make 60 treatment
modifications. Twenty-five of 140 (17%) had a reduction
of total dose, 26/140 (18%) had exclusion of the small
intestine by shrinking fields, or patient positioning
and 13/140 (9%) had displacement of the small intestine
by distention of the bladder. No patient developed small
intestine injury. The disease free survival for cervix
cancer was 27/33 (82%), corpus cancer 68/79 (86%) and
ovarian cancer 5/11 (45%). Pelvic failure was observed
in 19/123 patients who received definitive or adjunct
irradiation. One patient with corpus cancer and three
patients with ovarian cancer might have benefited from
the use of a larger treatment volume or a higher total
dose.
- Language of Publication
- English
- Unique Identifier
- 83290386
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- MeSH Heading (Major)
- Genital Neoplasms, Female|RA/*RT/SU; Intestine,
Small|RA/*RE; Radiation Injuries|*PC
- MeSH Heading
- Adult; Aged; Drug Therapy, Combination; Female; Human;
Middle Age; Neoplasm Staging; Palliative Care;
Postoperative Care; Preoperative Care; Radiotherapy
Dosage
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0360-3016
- Country of Publication
- UNITED STATES
Record 57 from database: MEDLINE
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- Title
- Long-term survivors after resection for primary liver
cancer. Clinical analysis of 19 patients surviving more
than ten years.
- Author
- Zhou XD; Tang ZY; Yu YQ; Yang BH; Lin ZY; Lu JZ; Ma ZC;
Tang CL
- Address
- Liver Cancer Institute, Shanghai Medical University,
People's Republic of China.
- Source
- Cancer, 1989 Jun, 63:11, 2201-6
- Abstract
- From July 1958 to June 1978, a total of 333 cases with
pathologically proven primary liver cancer (PLC) were
admitted to the Zhong Shan Hospital, Shanghai Medical
University, Shanghai, the people's Republic of China. Of
these, 39.6% (132 of 333) were resected and 14.4% (19 of
132) survived over 10 years after resection for PLC.
These 19 patients surviving over 10 years were
investigated in this paper. All 19 patients underwent
radical resection, including right hemihepatectomy in
two cases, left hemihepatectomy in ten cases, left
lateral segmentectomy in three cases, and local
resection in four cases. By the end of June 1988,
follow-up varied from 10 years and 1 month to 26 years
and 7 months, with a mean follow-up of 15 years and 4
months. All 19 patients are still alive with free of
disease. The longest survival patient had a tumor
measuring 10 X 8 X 6 cm in size and underwent local
resection. Upon follow-up after 26 years and 7 months,
the patient was found to be still living and well. Two
patients with intraperitoneal ruptured PLC have survived
for 19 years and 4 months, and 16 years and 11 months,
respectively, after resection of the tumors free of
disease and have returned to work. Subclinical
recurrence of PLC was discovered in one patient in whom
reoperation with cryosurgery was carried out. The
patient has been in good condition with negative
alpha-fetoprotein (AFP) for 8 years and 10 months after
cryosurgery. Subclinical solitary pulmonary metastasis
was detected in two patients because of a secondary rise
in AFP level. Reoperations were carried out and the
metastatic tumors were removed. These two patients are
still in good health with negative AFP 9 years and 6
months, and 10 years and 1 months, respectively, after
reoperation. These results indicate that early and
radical resection are the principal factors influencing
long-term survival; reoperation for subclinical
recurrence and solitary metastasis remains an important
approach to prolong survival further; intraperitoneal
rupture of PLC does not exclude the possibility of cure;
new surgical techniques, such as cryosurgery and
bloodless hepatectomy, have been shown to be effective
in some patients.
- Language of Publication
- English
- Unique Identifier
- 89248806
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- MeSH Heading (Major)
- Liver Neoplasms|AN/*MO/PA/SU
- MeSH Heading
- alpha-Fetoproteins|AN; Adult; Female; Follow-Up
Studies; Human; Male; Middle Age; Neoplasm Recurrence,
Local
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 58 from database: MEDLINE
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- Title
- Surgical treatment of isolated abdominal wall
metastasis in colorectal cancer.
- Author
- Ledesma EJ; Tseng M; Mittelman A
- Address
-
- Source
- Cancer, 1982 Nov, 50:9, 1884-7
- Abstract
- Isolated abdominal wall recurrence, following
resection of a primary large bowel adenocarcinoma, is an
infrequent finding. Over a ten year period, 22 patients
were submitted to en bloc resection of such localized
neoplastic foci. In 13 cases, recurrent tumor was
located in a previous midline or para median incision.
Nine patients underwent palliative radiotherapy and/or
chemotherapy once the recurrent disease was identified,
and were operated on when uncontrolled progression was
clinically evident. In all cases, 4-5 cm disease-free
margins were obtained. In eight patients it was possible
to close the defect primarily and 14 patients required
marlex mesh. Twelve patients were alive at two years and
ten patients at five-years follow-up mark. Mucin-producing
or poorly differentiated adenocarcinoma had the worse
prognosis. Synthetic prosthesis allowed for adequate
resections with little morbidity and acceptable cosmesis.
Symptomatic relief and long-term palliation can be
achieved with aggressive surgery. The role of adjuvant
chemotherapy and radiation therapy still needs to be
evaluated. The aggressiveness of poorly differentiated
and the mucin producing adenocarcinoma should temper
radical surgical exercises.
- Language of Publication
- English
- Unique Identifier
- 83001660
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- MeSH Heading (Major)
- Abdominal Muscles|*SU; Abdominal Neoplasms|*SC/SU;
Adenocarcinoma|*SC/SU; Colonic Neoplasms|*PA; Rectal
Neoplasms|*PA
- MeSH Heading
- Human; Neoplasm Recurrence, Local; Palliative Care
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 59 from database: MEDLINE
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- Title
- Effective chemotherapy for esophageal cancer with
methotrexate, bleomycin, and
cis-diamminedichloroplatinum II.
- Author
- Vogl SE; Greenwald E; Kaplan BH
- Address
-
- Source
- Cancer, 1981 Dec, 48:12, 2555-8
- Abstract
- Ten patients with squamous cancer of the esophagus
were treated with an outpatient regimen combining
cis-diamminedichloroplatinum (II), methotrexate and
bleomycin. Nine of these had metastatic disease or
recurrence after radiotherapy. Objective responses were
noted in 50%, regardless of performance status or
metastatic site. None of three patients with prior
radiation therapy responded, however. Median duration of
response was six months. Responders survived a median of
eight months versus five months for nonresponders. Three
patients had severe hematologic toxicity. A single
patient with massive disease confined to the esophagus
had an excellent response to six weeks of chemotherapy
before radical irradiation. He is disease-free after two
years but is paraplegic from radiation myelitis. This
chemotherapy program is an effective palliative therapy
for metastatic esophageal cancer. Its safety and
efficacy as part of the initial treatment of local
disease should be further investigated.
- Language of Publication
- English
- Unique Identifier
- 82069931
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- MeSH Heading (Major)
- Bleomycin|*AD; Cisplatin|*AD; Esophageal Neoplasms|*DT/MO/RT;
Methotrexate|*AD
- MeSH Heading
- Aged; Case Report; Drug Administration Schedule; Drug
Therapy, Combination; Human; Male; Neoplasm Metastasis;
Palliative Care; Pilot Projects; Support, U.S. Gov't,
P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 60 from database: MEDLINE
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- Title
- The significance of the internal mammary lymph nodes
in medially located breast cancer.
- Author
- Roseman JM; James AG
- Address
-
- Source
- Cancer, 1982 Oct, 50:7, 1426-9
- Abstract
- The efficacy of adjuvant radiotherapy for medial
breast cancers in Stage I or II disease was studied with
a retrospective clinical analysis. All cases of breast
cancer free of axillary node metastases at the time of
standard or modified radical mastectomy were included.
These were grouped by location and size of the primary
tumor. There were 76 medial lesions, including those in
the 6:00 or 12:00 axis. Seventeen of these had received
postoperative radiation. Lateral tumors included 59. The
size was based on the largest linear dimension and
grouped less than or equal to 2 cm or greater than 2 cm.
At the time of initial recurrence, all areas of
metastases were determined. The data suggests that: (1)
medial breast cancers have a greater rate of recurrence
than lateral ones; (2) adjuvant radiation for medial
lesions decreases that recurrence rate to the range of
lateral tumors; (3) large lesions may have a greater
chance for local recurrence as well as medial lesions of
all sizes; and (4) the potential problems with local
recurrence may be diminished with adequate radiotherapy
as an adjunctive measure. When recurrence does occur,
prior radiotherapy seems to delay the appearance of that
recurrence.
- Language of Publication
- English
- Unique Identifier
- 82258861
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- MeSH Heading (Major)
- Breast Neoplasms|*PA/RT/SU; Carcinoma, Intraductal,
Noninfiltrating|*PA/RT/SU; Lymph Nodes|*PA
- MeSH Heading
- Breast; Female; Human; Neoplasm Recurrence, Local;
Neoplasm Staging; Prognosis; Retrospective Studies;
Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 61 from database: MEDLINE
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- Title
- Radiotherapy, chemotherapy, and tamoxifen as adjuncts
to surgery in early breast cancer: a summary of three
randomized trials.
- Author
- Rutqvist LE; Cedermark B; Glas U; Johansson H;
Rotstein S; Skoog L; Somell A; Theve T; Askergren J;
Friberg S; et al
- Address
- Radiumhemmet, Karolinska Hospital, Stockholm, Sweden.
- Source
- Int J Radiat Oncol Biol Phys, 1989 Mar, 16:3, 629-39
- Abstract
- The paper summarizes up-dated results of three
randomized adjuvant trials from the Stockholm Breast
Cancer Group. The objective of all studies included an
evaluation of the role of megavoltage radiation in the
primary management of patients with early breast cancer.
The first trial was started in 1971 and included 960
pre- and postmenopausal patients with operable disease.
The study compared adjuvant radiotherapy with surgery
alone. All patients were treated with a modified radical
mastectomy. There was a sustained improvement of the
recurrence-free survival with radiotherapy (p less than
0.001). Among node positive cases radiation reduced the
frequency of both loco-regional recurrence (p less than
0.001) and distant metastasis (p less than 0.01). This
observation indicates that distant dissemination in
subgroups of patients can originate from uncontrolled
local deposits of tumor cells, for instance in the
regional lymph nodes. No adverse effect from radiation
on long-term survival was observed. The second study was
started in 1976 and compared postmastectomy radiation
with adjuvant chemotherapy in pre- and postmenopausal
high-risk patients. At a mean follow-up of 6 1/2 years
there was no significant difference in recurrence-free
survival between the two treatments. However,
postmenopausal patients fared better with radiotherapy
(p less than 0.01). In this subgroup, radiation was more
effective than adjuvant chemotherapy in reducing both
distant metastases (p less than 0.01) and loco-regional
recurrences (p less than 0.001). In the third
trial--which only included postmenopausal patients--2
years of adjuvant tamoxifen was compared with no
adjuvant endocrine treatment. The number of treatment
failures was significantly reduced with tamoxifen (p
less than 0.01) but there was no significant overall
survival benefit. Subset analysis indicated that
tamoxifen improved the recurrence-free survival among
patients treated with adjuvant chemotherapy (p less than
0.01) but only to a level close to that achieved with
radiotherapy alone. Addition of tamoxifen to
radiotherapy failed to further increase the
recurrence-free survival.
- Language of Publication
- English
- Unique Identifier
- 89155256
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- MeSH Heading (Major)
- Antineoplastic Agents, Combined|*TU; Breast
Neoplasms|DT/RT/*SU; Tamoxifen|*TU
- MeSH Heading
- Aged; Combined Modality Therapy; Cyclophosphamide|AD;
Female; Fluorouracil|AD; Human; Mastectomy, Modified
Radical; Methotrexate|AD; Middle Age; Multicenter
Studies; Radiotherapy, High-Energy; Random Allocation;
Support, Non-U.S. Gov't; Sweden
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY
- ISSN
- 0360-3016
- Country of Publication
- UNITED STATES
Record 62 from database: MEDLINE
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- Title
- Surgical adjuvant chemotherapy with mitomycin C and
cyclophosphamide in Japanese patients with breast
cancer.
- Author
- Koyama H; Wada T; Takahashi Y; Nishizawa Y; Iwanaga T;
Aoki Y; Terasawa T; Kosaki G; Kajita A; Wada A
- Address
-
- Source
- Cancer, 1980 Dec, 46:11, 2373-9
- Abstract
- A controlled trial of surgical adjuvant chemotherapy
for breast cancer was carried out using 551 Japanese
patients. Single or combined treatment with mitomycin C
(0.2 mg/kg i.v. three times within five days
postoperatively) and cyclophosphamide (100 mg
postoperatively daily for four months or longer) was
used after radical surgery. In patients of the
chemotherapy group with one to three lymph nodes
involved in the axilla, the five-year cancer-free
survival rate was 84.8% compared with 57.3% in the
control group (P < 0.05), and the five-year
cumulative recurrence in distant sites was 5.1% compared
with 31.1% in the control (P < 0.05). The
effectiveness of chemotherapy was much less marked in
patients without nodal metastasis and with four or more
nodes involved. Histologically, scirrhous cancer was the
type that responded most favorably to chemotherapy, even
in patients without axillary involvement. Premenopausal
patients benefited more than postmenopausal patients
from chemotherapy. A combination of mitomycin C and
cyclophosphamide was more effective than their use
singly. The present chemotherapy regimen was effective
primarily in moderately advanced stages of breast cancer
with decreased incidence of distant metastasis.
- Language of Publication
- English
- Unique Identifier
- 81064256
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- MeSH Heading (Major)
- Breast Neoplasms|*DT/RT/SU; Cyclophosphamide|*AD/AE;
Mitomycins|*AD/AE
- MeSH Heading
- Adenocarcinoma, Scirrhous|DT; Adult; Aged; Clinical
Trials; Drug Administration Schedule; Drug Therapy,
Combination; Female; Human; Lymphatic Metastasis;
Mastectomy; Menopause; Middle Age; Prognosis; Recurrence
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 63 from database: MEDLINE
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- Title
- Adjuvant CMFVP versus melphalan for operable breast
cancer with positive axillary nodes: 10-year results of
a Southwest Oncology Group Study.
- Author
- Rivkin SE; Green S; Metch B; Glucksberg H; Gad el
Mawla N; Constanzi JJ; Hoogstraten B; Athens J; Maloney
T; Osborne CK; et al
- Address
- Puget Sound Oncology Consortium, Southwest Oncology
Group Statistical Center, Seattle, WA.
- Source
- J Clin Oncol, 1989 Sep, 7:9, 1229-38
- Abstract
- Four hundred forty-one women with operable breast
cancer with histologically positive axillary nodes were
randomized to receive either combination
cyclophosphamide (60 mg/m2 orally everyday for 1 year);
fluorouracil (300 mg/m2 intravenously [IV] weekly for 1
year); methotrexate (15 mg/m2 IV weekly for 1 year);
vincristine (0.625 mg/m2 IV for 10 weeks); prednisone
(30 mg/m2 orally days 1 to 14, 20 mg/m2 days 15 to 28,
10 mg/m2 days 29 to 42) (CMFVP) or single-agent
melphalan (L-PAM) (5 mg/m2 orally every day for 5 days
every 6 weeks for 2 years) chemotherapy after a modified
or radical mastectomy between January 1975 and February
1978. Patients were stratified according to menopausal
status and number of positive nodes (one to three, more
than three nodes) before randomization. Seventy-eight
patients were ineligible, most (56) because they were
registered more than 42 days from surgery. Maximum
duration of follow-up is 12 years, with a median of 9.8
years. The treatment arms were balanced with respect to
age, menopausal status, and number of positive nodes.
Among eligible patients, disease-free survival and
survival were superior with CMFVP (P = .002, .005,
respectively). At 10 years, 48% of patients treated with
CMFVP remain alive and disease-free and 56% remain
alive, compared with 35% alive and disease-free and 43%
alive on the L-PAM arm. Disease-free survival and
survival were significantly better with CMFVP compared
with L-PAM only in premenopausal patients and patients
with four or more positive nodes. Both regimens were
well tolerated, although toxicity was more severe and
more frequent with CMFVP. We conclude that after 10
years of follow-up, adjuvant combination chemotherapy
with CMFVP is superior to single-agent L-PAM in patients
with axillary node-positive primary breast cancer. The
major advantage is in premenopausal women and in
patients with more than three positive axillary nodes.
- Language of Publication
- English
- Unique Identifier
- 89361556
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- MeSH Heading (Major)
- Antineoplastic Agents, Combined|AE/*TU; Breast
Neoplasms|*DT/MO/SU; Melphalan|*TU
- MeSH Heading
- Age Factors; Clinical Trials; Combined Modality
Therapy; Comparative Study; Cyclophosphamide|AD; Drug
Administration Schedule; Female; Fluorouracil|AD;
Follow-Up Studies; Human; Lymphatic Metastasis|MO;
Mastectomy, Modified Radical; Mastectomy, Radical;
Methotrexate|AD; Prednisone|AD; Support, U.S. Gov't,
P.H.S.; Vincristine|AD
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED
TRIAL
- ISSN
- 0732-183X
- Country of Publication
- UNITED STATES
Record 64 from database: MEDLINE
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- Title
- Is there always a role for radical prostatectomy in
the treatment of localized prostate cancer?
- Author
- Di Silverio F; DEramo G; Buscarini M; Casale P; Di
Nicola S; Colella D; Sciarra A
- Address
- Department of Urology, University of Rome La Sapienza.
- Source
- Minerva Urol Nefrol, 1995 Sep, 47:3, 117-24
- Abstract
- The efficacy of radical prostatectomy on localized
prostate cancer is well documented. However if a high
risk for patients suffering from prostate cancer and
effectiveness of treatment would be documented, the
advantage of the therapy on the natural history of the
disease must be demonstrated. Johansson et al. analyzed
the natural history of 223 untreated localized prostate
cancer with a mean follow up of 123 months. Only 8.5% of
the patients died of prostate cancer. The 10 year
disease specific survival rate was 86.8%. The
progression free survival rate was 53.1%. Zincke et al.
reported that the disease specific survival of the T1 T2
submitted to radical prostatectomy at 15 years was 93%
and the survival free of disease was 70%. Our data on
localized prostate cancer submitted to radical
prostatectomy showed that the disease specific survival
and the progression free survival after 5 years of
follow-up were 99% and 85.7% respectively. Fleming,
focusing on life expectancy, demonstrated that radical
prostatectomy provides some benefit compared with
watchful waiting for patients younger than 70 years. The
greatest marginal benefits of treatment arise when we
assume higher metastatic rates and higher treatment
efficacy. In fact in this case, radical prostatectomy
offers 3.5 years of improvement in quality of life
adjusted survival in younger patients with moderately or
poorly differentiated tumors. Radical prostatectomy can
particularly benefit selected groups of patients with
localized prostate cancer. The grade of differentiation
has been shown to be the most powerful predictor in
several series. DNA ploidy and tumor volume may be other
reliable prognostic factors. Among all the parameters
considered, the two with greatest effect in determining
the outcome of treatment compared to watchful waiting
were the rate of progression to metastatic disease in
untreated patients and the estimated efficacy of
treatment in reducing the metastatic rate.
- Language of Publication
- English
- Unique Identifier
- 96275317
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- MeSH Heading (Major)
- Prostatectomy|*/MT; Prostatic Neoplasms|CL/MO/*SU
- MeSH Heading
- Age Factors; Aged; Human; Male; Neoplasm Staging;
Prognosis; Risk Factors; Survival Rate; Treatment
Outcome
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW LITERATURE
- ISSN
- 0393-2249
- Country of Publication
- ITALY
Record 65 from database: MEDLINE
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- Title
- Prognostic significance of clinical nodal involvement
in patients treated by radical radiotherapy for a
locally advanced breast cancer.
- Author
- Vilcoq JR; Fourquet A; Jullien D; Gautier C; Calle R;
Ghossein NA
- Address
-
- Source
- Am J Clin Oncol, 1984 Dec, 7:6, 625-8
- Abstract
- A group of 230 female patients, treated between
1960-1976 with radical megavoltage radiotherapy for
locally advanced breast cancer (T3 greater than 7 cm-T4
Stage), was analyzed retrospectively. Those with
inflammatory cancer or evidence of disseminated
metastatic disease were excluded. Clinical axillary
nodal involvement appears to be a very important
prognostic feature. Actuarial disease-free survival at 5
years for the 109 patients with clinically negative
nodes (N0N1a) is 52%; whereas it is 28% (p less than
0.001) for the 121 patients with clinically involved
nodes (N1b, N2-N3). The 5-year survival following
salvage surgery, which was performed on 92/230 patients
(40%), correlated with the initial nodal status. It is
62% for the N0 group, but only 27% for those with
clinically involved nodes. The survival of the 138 (60%)
patients who were treated by radiotherapy only is
similar to that obtained in patients who had secondary
salvage surgery. This study reinforces the need to
stratify patients with locally advanced breast cancer
according to the initial clinical status of the axilla
when either therapeutic trials are contemplated or the
results of treatment are reported. Adjuvant systemic
treatment should be strongly considered in patients with
clinically involved nodes, since the survival obtained
by local treatment alone is poor.
- Language of Publication
- English
- Unique Identifier
- 85145642
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- MeSH Heading (Major)
- Breast Neoplasms|*PA/RT
- MeSH Heading
- Adult; Aged; Axilla; Female; Follow-Up Studies; Human;
In Vitro; Lymphatic Metastasis; Middle Age; Neoplasm
Recurrence, Local; Prognosis; Radiotherapy, High-Energy;
Retrospective Studies
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0277-3732
- Country of Publication
- UNITED STATES
Record 66 from database: MEDLINE
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- Title
- The acceptable delay between biopsy and radical
mastectomy in breast cancer patients.
- Author
- Toi M; Nakamura T; Wada T; Yamamoto A; Toge T; Niimoto
M; Hattori T
- Address
- Department of Surgery, Hiroshima University, Japan.
- Source
- Jpn J Surg, 1989 Nov, 19:6, 679-83
- Abstract
- The effects on the prognosis of breast cancer, of the
delay between biopsy and radical mastectomy were studied
in 394 patients. No delay had been experienced by 148
cases (no delay group), no biopsy had been performed in
166 cases (no biopsy group) and 80 cases had experienced
a delay of 1 day or longer after having had a biopsy
taken at a different institution (delay group). The
recurrence rate of the no delay group was 10.8 per cent
(16/148), whereas that of the delay group was 18.8 per
cent (15/80). The relapse free survival rate of the no
delay group was superior to that of the delay group
(Kaplan Meier's method: p less than 0.05). The delay
group was further divided into two groups according to
the duration of delay, namely: a group whose delay was
less than 7 days and another whose delay was longer than
8 days. There was no significant difference between the
relapse free survival rates of the no delay group and
the less than 7 days group, however, a significant
difference was observed between the no delay group and
the longer than 8 days delay group (p less than 0.05).
The acceptable delay between biopsy and radical
mastectomy may therefore be concluded as less than 7
days.
- Language of Publication
- English
- Unique Identifier
- 90112954
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- MeSH Heading (Major)
- Breast Neoplasms|*PA/*SU; Mastectomy, Radical|*
- MeSH Heading
- Biopsy; Biopsy, Needle; Female; Human; Prognosis; Time
Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0047-1909
- Country of Publication
- JAPAN
Record 67 from database: MEDLINE
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- Title
- Breast cancer treatment--current status. 3. Simple
excision with irradiation.
- Author
- Wilson JF
- Address
-
- Source
- Postgrad Med, 1983 Sep, 74:3, 151-5, 158
- Abstract
- Although radical dissection has been standard
treatment for breast cancer for over 80 years, sharp
controversy persists regarding the best management for
early breast cancer. The trend over the past 20 years
has been toward progressively limited surgery followed
by irradiation. Recently, results of several
retrospective series of early breast cancer in which
simple excision of a small tumor was followed by
aggressive irradiation showed that tumor control and
relapse-free survival rates were equivalent to those
achieved by other therapies. Further confirmation of
these findings is needed before this breast-sparing
technique can become the treatment of choice in early
breast cancer.
- Language of Publication
- English
- Unique Identifier
- 83299654
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- MeSH Heading (Major)
- Breast Neoplasms|MO/*TH
- MeSH Heading
- Axilla; Brachytherapy; Breast|SU; Female; Follow-Up
Studies; Human; Lymph Node Excision; Postoperative Care;
Radiotherapy, High-Energy; Retrospective Studies
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0032-5481
- Country of Publication
- UNITED STATES
Record 68 from database: MEDLINE
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- Title
- Treatment of primary breast cancer with immunotherapy.
Comparison with adjuvant chemotherapy and radiation
therapy.
- Author
- Humphrey LJ; Taschler Collins S; Volenec FJ
- Address
-
- Source
- Am J Surg, 1984 Nov, 148:5, 649-52
- Abstract
- For the first time, data on 78 breast cancer patients
treated by modified radical mastectomy and adjuvant
immunotherapy have been reported. Thirty-nine lymph node
negative patients with uninvolved lymph nodes had a
projected 5 year survival rate of 94 percent and 39
patients with involved nodes had a projected 5 year
survival rate of 77 percent and a disease-free survival
rate of 70 percent. Results have been presented
according to UICC staging. The 100 percent survival rate
of stage I patients has been compared with rates
obtained by treatment of breast cancer with radiation
therapy as the principal modality. The preliminary data
are promising enough to warrant randomized, prospective
trials with the other adjuvant modalities.
- Language of Publication
- English
- Unique Identifier
- 85044516
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- MeSH Heading (Major)
- Breast Neoplasms|DT/MO/RT/*TH; Immunotherapy|*MT
- MeSH Heading
- Antineoplastic Agents|TU; Clinical Trials; Comparative
Study; Female; Human; Lymphatic Metastasis; Mastectomy;
Support, Non-U.S. Gov't
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE
- ISSN
- 0002-9610
- Country of Publication
- UNITED STATES
Record 69 from database: MEDLINE
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- Title
- Radiotherapy vs. hormonal therapy for the management
of locally recurrent prostate cancer following radical
prostatectomy.
- Author
- Anscher MS; Prosnitz LR
- Address
- Division of Radiation Oncology, Duke University
Medical Center, Durham, NC 27710.
- Source
- Int J Radiat Oncol Biol Phys, 1989 Nov, 17:5, 953-8
- Abstract
- Forty patients out of 273 who had undergone radical
surgery for adenocarcinoma of the prostate at Duke
University Medical Center between 1970 and 1983
developed palpable, biopsy-proven local recurrence
without evidence of distant metastases. Of these 40
patients, 16 were treated with irradiation alone (Group
I) and 16 patients were treated with hormonal therapy
only (Group II). The remaining eight patients received
either no therapy (4 patients) or both radiotherapy and
hormonal therapy (4 patients) and are not further
analyzed. Local control, as determined by palpation, was
achieved in 14/16 patients in Group I versus only 7/16
patients in Group II (p less than 0.05). Subsequently,
six patients in each group have relapsed, all with
distant metastases. Thus, 8/16 patients in Group I
remain alive without disease versus only 1/16 patients
in Group II (p less than 0.05). There was no difference
in survival between Groups I and II. No patient in
either group has died free of disease. In Group I, 4/16
patients have died with cancer. Six of 16 in Group II
have died with cancer. Severe complications occurred
more frequently following irradiation compared to
hormonal therapy. Irradiation appears to be superior to
hormonal therapy in achieving local control and
prolonging disease-free survival. Neither therapy
conveys an advantage over the other in terms of
survival. Thus, even if local control is achieved,
distant failure may be an inevitable consequence of
locally recurrent prostate cancer. Therefore, prevention
of local recurrence after radical prostatectomy is of
paramount importance. These findings support the use of
adjuvant post-operative irradiation in patients at high
risk for local recurrence.
- Language of Publication
- English
- Unique Identifier
- 90036302
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- MeSH Heading (Major)
- Adenocarcinoma|*DT/PA/RT/SU; Hormones|*TU; Neoplasm
Recurrence, Local|*; Prostatic Neoplasms|*DT/PA/RT/SU
- MeSH Heading
- Aged; Combined Modality Therapy; Comparative Study;
Follow-Up Studies; Human; Male; Middle Age;
Prostatectomy
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0360-3016
- Country of Publication
- UNITED STATES
Record 70 from database: MEDLINE
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- Title
- Tumour regression after intralesional injection of
interleukin 2 (IL-2) in bladder cancer. Preliminary
report.
- Author
- Pizza G; Severini G; Menniti D; De Vinci C; Corrado F
- Address
-
- Source
- Int J Cancer, 1984 Sep, 34:3, 359-67
- Abstract
- Six bladder cancer patients received intralesional
injections by needle, under cystoscopic control, of
1969-4046 units (U) of xenogeneic IL-2 of high
biological activity (324 U/ml; 397 micrograms/ml
protein; 1.22 protein/U ratio). The treatment was spread
over 7-54 days and 0.5 ml was injected each time. In 3/6
patients complete tumour regression was seen 43, 60 and
105 respectively days after the first IL-2 injection. In
2 a 70% regression was observed at days 45 and 75. In
the last patient massive necrosis throughout the tumour
mass was recorded on day 25 at radical cystectomy. In
order to evaluate the minimum IL-2 U required to obtain
positive clinical results and/or to assess whether the
anti-tumour effect observed could be ascribed to the
foreign protein of bovine origin contained in our IL-2
preparation, 4 additional bladder cancer patients were
treated in 7-14 days with 156-1404 U of a second IL-2
lot with a much lower biological activity and similar
protein content (52 U/ml; 289 micrograms/ml of protein;
5.55 protein/U ratio). No clinical or histological
improvement was noted over a 42- to 54-day observation
period. When we evaluated the 2 groups of patients by
Student's t-test for both total U injected and U/kg of
body weight (bw) we found a statistically significant
differences (0.0025 less than p less than 0.0005 and p
less than 0.0005, respectively). In contrast, no
difference was seen for the injected protein amounts.
The reported observations are in favour of a
dose-dependent anti-tumour action mediated by IL-2
instead of foreign proteins. In none of the patients
treated were any early or late adverse clinical side
effects observed. Immunological monitoring (E, EAC,
E-active rosettes, mitogen lymphocyte stimulations and
leukocyte migration inhibition in the presence of
allogeneic bladder cancer cells) performed on the
peripheral blood (PB) showed significant but contrasting
modifications after IL-2 injection. There was no clear
correlation with the clinical course. The patients in
whom we observed complete regression are still tumour
free after 2, 4 and 7 months. In addition, in all the
patients of the first group we observed an increase in
tumour lymphoid infiltrate after IL-2 injection and in 2
patients lymphoid pseudo-follicles were also noted. In 2
of these patients we also observed scar-like areas in
the place of the tumours previously seen.
- Language of Publication
- English
- Unique Identifier
- 85005794
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- MeSH Heading (Major)
- Bladder Neoplasms|IM/PA/*TH; Interleukin-2|BI/PD/*TU
- MeSH Heading
- Aged; Animal; Case Report; Female; Guinea Pigs; Human;
Immunotherapy; Lymphocyte Transformation|DE; Male;
Middle Age; Mitogens; Reference Values; Rosette
Formation
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0020-7136
- Country of Publication
- DENMARK
Record 71 from database: MEDLINE
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- Title
- Long-range results for breast cancer patients treated
by radical mastectomy and postoperative radiation
without adjuvant chemotherapy: an update [see comments]
- Author
- Fletcher GH; McNeese MD; Oswald MJ
- Address
- Department of Clinical Radiotherapy, University of
Texas M.D. Anderson Cancer Center, Houston 77030.
- Source
- Int J Radiat Oncol Biol Phys, 1989 Jul, 17:1, 11-4
- Abstract
- Between 1963 and 1977, 941 patients with carcinoma of
the breast received, at the University of Texas M.D.
Anderson Cancer Center, peripheral lymphatic irradiation
alone or with chest wall irradiation after a radical or
modified radical mastectomy. None of the patients
received adjuvant chemotherapy. The incidence of
patients with histologically involved axillary nodes was
70%. The lymphatics of the apex of the axilla, of the
supraclavicular area, and of the internal mammary chain
were irradiated in patients with histologically positive
axillary nodes and/or in patients with central or inner
quadrant primaries regardless of the axillary status.
When in 1963 an electron beam became available, chest
wall irradiation has been added to the peripheral
lymphatics irradiation, primarily when there was a heavy
infestation of the axillary nodes. The disease-free
survival curves tend to flatten out at 10 years. At 10
and 20 years, the disease-free survival rates are
respectively 55% and 50% for all patients, 44% and 40%
for all patients with positive nodes, 56% and 48% for
the patients with one to three positive nodes, and 33%
and 30% for the patients with four or more positive
nodes. The comparison of the mortality curves between
the general population and the breast cancer patients
seems to indicate a cured fraction, since the curves
become parallel at 17 years. The highest incidence of
failures is between 0 and 5 years, still a significant
incidence between 5 and 10 years, but after 10 years the
incidence of failures is relatively small.
- Language of Publication
- English
- Unique Identifier
- 89308127
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- MeSH Heading (Major)
- Breast Neoplasms|MO/*RT/*SU; Mastectomy, Radical|*
- MeSH Heading
- Cobalt Radioisotopes|TU; Combined Modality Therapy;
Female; Follow-Up Studies; Human; Lymphatic Metastasis;
Mastectomy, Modified Radical; Prognosis; Radiotherapy
Dosage; Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0360-3016
- Country of Publication
- UNITED STATES
Record 72 from database: MEDLINE
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- Title
- Conservative management of operable breast cancer:
ten years experience at the Foundation Curie.
- Author
- Calle R; Pilleron JP; Schlienger P; Vilcoq JR
- Address
-
- Source
- Cancer, 1978 Oct, 42:4, 2045-53
- Abstract
- 514 patients were treated for a surgically operable
(T1, T2, T3, N0, N1a, N1b) infiltrating breast
carcinoma at the Foundation Curie, Paris, France, from
1960 to 1970 inclusive. Patients with tumors 3 cm or
less and without axillary adenopathy had lumpectomy
followed by radiotherapy. Patients with larger tumors
and all patients with clinically significant lymph
nodes (N1b) had exclusive radiotherapy (without
lumpectomy). 120 had lumpectomy and 394 had exclusive
radiotherapy. The five and ten years absolute
survivals, free of disease (N.E.D.), for the
lumpectomy are 85% and 75%, respectively. 12% had
secondary surgery for local recurrence. The cosmetic
results were satisfactory in 98%, with no severe
radiation sequelae. The five and ten years, N.E.D., of
the exclusive radiotherapy group are 68% and 43%. 55%
had secondary surgery for persistent or recurrent
disease. The cosmetic results were satisfactory in
85%. There were only three patients with severe
radiation sequelae. The overall survival for 514
patients at five and ten years are 72% and 51%.
Two-thirds of patients, alive at five years, had a
preserved breast. Our conservative treatment resulted
in survival at five and ten years comparable to those
of radical surgery.
- Language of Publication
- English
- Unique Identifier
- 79043553
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- MeSH Heading (Major)
- Breast Neoplasms|*TH
- MeSH Heading
- Adult; Aged; Breast Diseases|ET; Comparative Study;
Female; Human; Mastectomy|MT; Middle Age; Radiation
Injuries|ET; Radiotherapy Dosage; Radiotherapy,
High-Energy; Remission, Spontaneous; Skin Diseases|ET;
Time Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 73 from database: MEDLINE
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- Title
- Preliminary 3-year results of 12 versus 6 cycles of
surgical adjuvant CMF in premenopausal breast cancer.
- Author
- Tancini G; Bajetta E; Marchini S; Valagussa P;
Bonadonna G; Veronesi U
- Address
-
- Source
- Cancer Clin Trials, 1979 Win, 2:4, 285-92
- Abstract
- In hope of reducing the duration of adjuvant
treatment in premenopausal patients with operable
breast cancer and histologically positive axillary
lymph nodes, a prospective controlled study was
started in September 1975. A total of 160 patients
were randomized to receive 12 cycles of adjuvant CMF,
while 165 were allocated to receive 6 cycles. At 3
years from radical mastectomy, the relapse-free
survival was 85.4% in the 12-cycle group compared to
82.6% for the 6-cycle subset (P = 0.29). In both
treatment groups, the incidence of treatment failure
was directly proportional to the number of involved
axillary nodes and to the clinical tumor size.
Drug-induced amenorrhea as well as estrogen receptor
status failed to significantly affect the results
obtained. Treatment failures were more often
documented in distant sites, while only 4--5% relapse
was observed in local-regional areas. Overall survival
was also similar for both treatment arms (86.2% vs.
85.1%, P = 0.49). Toxicity was moderate and reversible
and no drug-induced neoplasms were so far observed.
Present results achieved with 6 cycles of adjuvant CMF
appear encouraging. However, they are still too
preliminary to recommend the routine use of 6 cycles
instead of the classical 12 cycles.
- Language of Publication
- English
- Unique Identifier
- 80132736
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- MeSH Heading (Major)
- Breast Neoplasms|*TH; Cyclophosphamide|*AD;
Fluorouracil|*AD; Methotrexate|*AD
- MeSH Heading
- Adult; Antineoplastic Agents|AE; Bone Marrow|DE;
Clinical Trials; Comparative Study; Drug
Administration Schedule; Drug Therapy, Combination;
Female; Human; Middle Age; Remission, Spontaneous;
Support, U.S. Gov't, P.H.S.; Time Factors
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED
CONTROLLED TRIAL
- ISSN
- 0190-1206
- Country of Publication
- UNITED STATES
Record 74 from database: MEDLINE
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- Title
- Stage Ib, IIa, and IIb cervix cancer, postsurgical
staging, and prognosis.
- Author
- Matsuyama T; Inoue I; Tsukamoto N; Kashimura M;
Kamura T; Saito T; Uchino H
- Address
-
- Source
- Cancer, 1984 Dec, 54:12, 3072-7
- Abstract
- Two hundred fifty-five cases of International
Federation of Gynecology and Obstetrics (FIGO) Stage
Ib, IIa, and IIb cases of cervical cancer were
analyzed following radical surgery with regard to the
extent of invasion into vagina, parametria, and pelvic
lymph nodes. Restaging was carried out based on the
findings. Discrepancies were found between FIGO stages
and the actual extent of the disease, particularly in
Stage IIb. Among 99 cases of Stage IIb, only 42.4%
were correctly staged. The 5-year disease-free
survival by FIGO and postsurgical stagings were,
respectively: Ib, 88.4% and 87.0%; IIa, 85.2% and
95.0%; IIb, 70.7% and 62.3%. Prognostic significance
in the pathologic examination of operated materials
was demonstrated when there were deep stromal
invasions of cancer cell or parametrial invasions or
pelvic lymph node metastases. When cancer was present
in both of the parametrium and pelvic lymph nodes, the
prognosis of the patient worsened (5-year survival
rate, 41.4%).
- Language of Publication
- English
- Unique Identifier
- 85048663
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- MeSH Heading (Major)
- Cervix Neoplasms|MO/*PA/RT
- MeSH Heading
- Adenocarcinoma|PA; Adult; Aged; Female; Human;
Lymphatic Metastasis; Middle Age; Neoplasm Recurrence,
Local; Neoplasm Staging; Prognosis; Radiotherapy|AE;
Vaginal Neoplasms|PA
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 75 from database: MEDLINE
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- Title
- Radical surgical procedure improves survival time in
patients with recurrent ovarian cancer.
- Author
- Jänicke F; Hölscher M; Kuhn W; von Hugo R; Pache
L; Siewert JR; Graeff H
- Address
- Frauenklinik und Poliklinik, UniversitÂat MÂunchen,
Germany.
- Source
- Cancer, 1992 Oct, 70:8, 2129-36
- Abstract
- BACKGROUND. There is plenty of evidence that
survival time associated with advanced ovarian cancer
is predominantly related to the amount of residual
tumor after primary operation. However, there are only
few and inconclusive reports concerning the effect of
second debulking procedures on survival time after
relapse. METHODS. To evaluate the effect of radical
second operation, 30 patients with clinically
diagnosed relapses had second operations after a
median recurrence-free interval of 16 months.
Considerable efforts were made to resect all tumor
tissue. Complete resection was achieved in 14 of 39
(47%) patients, and residual tumors smaller than 2 cm
remained in 12 (40%) patients. In 19 (63%) patients,
intestinal resections were necessary. Operation time,
blood units needed, hospital stay, and complication
rates were comparable to those associated with primary
debulking procedures. RESULTS. Survival time after
second operation was closely correlated with the
residual tumor remaining after second surgical
procedure and also with the length of the
recurrence-free interval. Patients with complete
resections had significantly longer survival times
than those with residual tumors of less than 2 cm
(median, 29 months versus 9 months; P = 0.004).
Patients with a recurrence-free interval of more than
12 months had a longer survival time than those with a
shorter disease-free time (median, 29 months versus 8
months; P = 0.002). Postoperative treatment also was
shown to influence survival time, whereas grade of the
tumor (P = 0.74), age of the patient (P = 0.87), and
initial FIGO stage (P = 0.58) had no influence on
survival time after second operation. Multivariate
analysis (Cox regression) revealed that residual tumor
after second surgical procedure (relative risk, 4.7)
was the most important independent variable predicting
survival time after second surgical procedure.
Recurrence-free interval (relative risk, 2.7) and
postoperative (second-line) treatment (relative risk,
3.0) were equally potent variables. Residual tumor
after primary operation, was almost significant (P =
0.06) in the univariate analysis, but was canceled in
the multivariate setting by the recurrence-free
interval. Again, FIGO stage, grade of the tumor, and
patient age had no predictive value. CONCLUSIONS. The
authors conclude that radical surgical procedure can
prolong survival times in patients with recurrent
ovarian cancer. Patients who had a complete resection
of cancer tissue in the primary operation or those who
experienced a disease-free interval of more than 12
months after primary operation are most likely to
benefit from second operation in recurrent ovarian
cancer. Radical surgical procedure should be offered
to these patients to enhance efficacy of second-line
chemotherapy, which is of limited value in bulky
recurrent disease.
- Language of Publication
- English
- Unique Identifier
- 93007750
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- MeSH Heading (Major)
- Neoplasm Recurrence, Local|*MO/*SU; Ovarian
Neoplasms|*MO/PA/*SU
- MeSH Heading
- Adult; Aged; Anastomosis, Surgical; Female; Human;
Intestines|SU; Lymph Node Excision; Middle Age;
Quality of Life; Reoperation; Retrospective Studies;
Survival Analysis; Time Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 76 from database: MEDLINE
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- Title
- Interstitial radiotherapy with Ir192 in vulvar
cancer.
- Author
- Carlino G; Parisi S; Montemaggi P; Pastore G
- Address
-
- Source
- Eur J Gynaecol Oncol, 1984, 5:3, 183-5
- Abstract
- Radical surgical intervention is not always possible
in vulvar tumours, particularly in infiltrating forms
of paraurethral locations. In our case-series, the
supplementary performance of Curietherapy,
particularly with Radium substitutes (Iridium 192) and
following the afterloading method, has enabled us not
only to obtain long disease-free periods but also,
coupled with the "large volume" of External
Radiotherapy, to master forms exceeding the surgical
action scope.
- Language of Publication
- English
- Unique Identifier
- 84236254
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- MeSH Heading (Major)
- Brachytherapy|*; Iridium|*TU; Radioisotopes|*TU;
Vulvar Neoplasms|*RT/SU
- MeSH Heading
- Combined Modality Therapy; Female; Human; Neoplasm
Recurrence, Local
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0392-2936
- Country of Publication
- ITALY
Record 77 from database: MEDLINE
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- Title
- Contemporary cystectomy with pelvic node dissection
compared to preoperative radiation therapy plus
cystectomy in management of invasive bladder cancer.
- Author
- Skinner DG; Lieskovsky G
- Address
-
- Source
- J Urol, 1984 Jun, 131:6, 1069-72
- Abstract
- Between August 1971 and August 1982, 197 consecutive
patients underwent single stage radical cystectomy
with pelvic lymph node dissection and urinary
diversion as definitive management of high grade,
invasive bladder cancer. In 100 patients 1,600 rad of
radiation therapy were given for 4 days preoperatively
and 97 patients underwent an operation only. Although
not constituting a prospective randomized study, an
analysis of these 2 groups of patients managed during
an 11-year period by the same surgical team, using
identical surgical technique, provides useful
information that questions the benefit of preoperative
radiation therapy in the management of high grade,
invasive bladder cancer. Other factors, such as
improved surgical technique with meticulous pelvic
node dissection as well as better preoperative and
postoperative care, may be responsible for survival
results of contemporary surgery only that equal those
reported following combination therapy protocols using
preoperative radiation therapy. Contemporary surgery
with or without preoperative radiation therapy yielded
a 5-year survival rate free of tumor of 75 per cent
for patients with pathologic stages P2 and P3A
disease, 44 per cent with P3A and P3B disease, and 36
per cent with P4 disease and positive pelvic nodes.
- Language of Publication
- English
- Unique Identifier
- 84216533
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- MeSH Heading (Major)
- Bladder|*SU; Bladder Neoplasms|RT/SU/*TH
- MeSH Heading
- Aged; Combined Modality Therapy; Female; Human;
Lymph Nodes|SU; Male; Middle Age; Pelvis; Preoperative
Care; Urinary Diversion
- Publication Type
- CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; JOURNAL
ARTICLE
- ISSN
- 0022-5347
- Country of Publication
- UNITED STATES
Record 78 from database: MEDLINE
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- Title
- Risk of local urethral recurrence after radical
cystectomy for bladder cancer.
- Author
- Beahrs JR; Fleming TR; Zincke H
- Address
-
- Source
- J Urol, 1984 Feb, 131:2, 264-6
- Abstract
- Radical cystectomy and urinary diversion were
performed on 349 patients with transitional cell
cancer of the bladder. Followup for 4 to 13 years
revealed that 91 and 83 per cent of the patients were
free of urethral recurrence 5 and 10 years after
cystectomy, respectively. Statistical elimination of
urethral recurrences did not improve the over-all
survival rate significantly. It appears that
supplementation of cystectomy with simultaneous
urethrectomy may not be justified if the urethra is
not involved by the cancer.
- Language of Publication
- English
- Unique Identifier
- 84138919
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- MeSH Heading (Major)
- Bladder Neoplasms|RT/*SU; Carcinoma, Transitional
Cell|RT/*SU; Urethra|*SU; Urinary Diversion|*
- MeSH Heading
- Adult; Aged; Follow-Up Studies; Human; Male; Middle
Age; Neoplasm Invasiveness; Risk; Urethral
Neoplasms|PC
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0022-5347
- Country of Publication
- UNITED STATES
Record 79 from database: MEDLINE
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- Title
- Prognostic value of hormone receptors in breast
cancer.
- Author
- Morimoto T; Komaki K; Yamamoto H; Yamakawa T; Tanaka
T; Sonoo H; Monden Y
- Address
- 2nd Department of Surgery, School of Medicine,
University of Tokushima, Japan.
- Source
- J Surg Oncol, 1988 Oct, 39:2, 101-7
- Abstract
- The aim of this study was to establish the role of
estrogen receptor (ER) and progesterone receptor (PgR)
as prognostic indicators for early recurrence and
survival. In all, among breast cancer patients, 166
patients who had undergone radical or extended radical
mastectomy were studied. These patients were treated
with adjuvant chemotherapy alone for 2-3 years after
surgery. No patients had adjuvant endocrine therapy.
Local recurrence and/or distant metastases were
treated by endocrine therapy and/or chemotherapy. The
relapse-free interval was not different between the
ER-positive and ER-negative patients. The postrelapse
survival curve was significantly different between the
two groups. There was no significant difference in the
relapse-free interval and the postrelapse survival
curve between the PgR-positive and PgR-negative
patients. These results suggest that ER is a good
predictor of the response to endocrine therapy given
after relapse, but not of early recurrence.
- Language of Publication
- English
- Unique Identifier
- 89013109
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- MeSH Heading (Major)
- Breast Neoplasms|*AN/MO; Receptors, Estrogen|*AN;
Receptors, Progesterone|*AN
- MeSH Heading
- Female; Human; Mastectomy, Radical; Neoplasm
Recurrence, Local; Prognosis
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0022-4790
- Country of Publication
- UNITED STATES
Record 80 from database: MEDLINE
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- Title
- Advanced head and neck cancer: response to and
toxicity of multimodality therapy.
- Author
- Chang H; Leone LA; Tefft M; Nigri PT
- Address
- Department of Radiation Therapy, Brown University
Medical School, Rhode Island Hospital, Providence,
RI 02903.
- Source
- Radiology, 1988 Sep, 168:3, 863-7
- Abstract
- This pilot study for resectable stage III and
stage IV squamous cell carcinoma of the head and
neck used a cytoreduction phase of preoperative
radiation with cisplatin, followed by an eradicative
treatment phase with radical surgery (group 1) or
radical dose radiation and cisplatin (group 2),
followed by adjuvant chemotherapy with
5-fluorouracil infusion and cisplatin delivered at
4-week intervals for six cycles following initial
radiation therapy to the primary site. A total of 43
patients were treated between January 1984 and
January 1987; 14 were classified with stage III
carcinoma, 28 with stage IV, and one patient was not
staged. Out of 43 patients, two did not complete
therapy. Forty-one patients completed the
eradicative phase of treatment. Complete tumor
clearance at the end of the eradicative treatment
phase was 88% (36 of 41 patients), 95% (18 of 19) in
group 1 and 82% (18 of 22) in group 2. Actuarial
recurrence-free survival was 61% at 3 years. Among
36 patients with complete tumor clearance after the
eradicative treatment phase, there was no
statistically significant difference for overall and
recurrence-free survival between group 1 and group
2. In general, toxicity was not excessive, although
mucositis, weight loss, and hematologic and
neurologic toxicity were observed in varying degrees
in these patients.
- Language of Publication
- English
- Unique Identifier
- 88304578
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- MeSH Heading (Major)
- Carcinoma, Squamous Cell|MO/*TH; Head and Neck
Neoplasms|MO/*TH
- MeSH Heading
- Adult; Aged; Antineoplastic Agents, Combined|AE/TU;
Cisplatin|AD; Combined Modality Therapy; Female;
Fluorouracil|AD; Human; Male; Middle Age; Pilot
Projects; Preoperative Care; Radiotherapy|AE/MT
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0033-8419
- Country of Publication
- UNITED STATES
Record 81 from database: MEDLINE
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- Title
- Cancer recurrence and survival rates after
anatomic radical retropubic prostatectomy for
prostate cancer: intermediate-term results.
- Author
- Catalona WJ; Smith DS
- Address
- Department of Surgery, Washington University
School of Medicine, St. Louis, Missouri, USA.
- Source
- J Urol, 1998 Dec, 160:6 Pt 2, 2428-34
- Abstract
- PURPOSE: We evaluate cancer recurrence and
survival rates following anatomic radical retropubic
prostatectomy. MATERIALS AND METHODS: From 1983
through August 1997, 1 surgeon performed anatomic
radical retropubic prostatectomy in 1,778 men (mean
age plus or minus standard deviation 63+/-7), using
a unilateral or bilateral nerve sparing modification
when feasible (93%). Postoperative adjuvant
radiation therapy (mean dose 60 Gy.) was given to 4%
of patients because of adverse pathological
findings. Patients were followed with semiannual
prostate specific antigen (PSA) tests and annual
digital rectal examinations. Followup PSA 0.3 ng./ml.
or greater was considered evidence of cancer
recurrence. We used Kaplan-Meier product limit
estimates to calculate 7-year cancer recurrence-free
probabilities, prostate cancer specific survival and
all cause survival (overall, and stratified by age,
preoperative PSA, tumor grade and tumor stage). We
used multivariate Cox proportional hazards models to
determine clinical and pathological parameters that
provided unique predictive information about cancer
recurrence. RESULTS: The 7-year recurrence-free
survival was significantly associated with lower
preoperative PSA (estimated probability of
nonprogression 76 to 93% for PSA less than 10),
nonpalpable, localized clinical stage (79%), lower
tumor grade (84 and 68% for well and moderately
differentiated, respectively) and localized
pathological stage (81% for pT1 or pT2) (all log
rank test p <0.0001) but not age at surgery. All
predictors except clinical stage and age remained
significant within the multivariate model.
Controlling for all other predictors, adjuvant
radiation therapy in patients with unfavorable
pathology was significantly associated with better
recurrence-free survival (p=0.02). The estimated
7-year prostate cancer specific survival rate was
97% and the all cause survival rate was 90%. Cancer
specific and all cause survival were significantly
associated with lower grade and localized
pathological stage (p <0.0001). CONCLUSIONS:
Anatomic radical retropubic prostatectomy with the
nerve sparing modification can be performed with
good cancer control.
- Language of Publication
- English
- Unique Identifier
- 99032309
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- MeSH Heading (Major)
- Neoplasm Recurrence, Local|*EP; Prostatectomy|*/MT;
Prostatic Neoplasms|*MO/PA/*SU
- MeSH Heading
- Adult; Aged; Disease Progression; Follow-Up
Studies; Human; Male; Middle Age; Multivariate
Analysis; Neoplasm Staging; Survival Rate
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0022-5347
- Country of Publication
- UNITED STATES
Record 82 from database: MEDLINE
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- Title
- Nitric oxide and oxygen radicals in infection,
inflammation, and cancer.
- Author
- Maeda H; Akaike T
- Address
- Department of Microbiology, Kumamoto University
School of Medicine, Kumamoto, 860-0811, Japan.
msmaedah@gpo.kumamoto-u.ac.jp
- Source
- Biochemistry (Mosc), 1998 Jul, 63:7, 854-65
- Abstract
- In recent years, accumulated evidence indicates
that free radical species and nitric oxide (NO) or
its derivatives are the key denominators in
carcinogenesis. Our present topics discussed in this
article will focus on the biological significance of
free radical generation induced by viral and
bacterial infections. In influenza virus infection
in mice, the level of xanthine oxidase (XO) at the
infected sites was elevated to a great extent. The
timing of paralleled induction of XO with that of
inducible NO synthase (iNOS) indicates efficient
simultaneous reaction: NO + O2*- --> ONOO- (peroxynitrite).
Peroxynitrite formation was identified by
immunostaining of nitrotyrosine at the local site of
infected organs. Peroxynitrite exhibits unique
chemical reactivities such as protein nitration,
DNA-strand breakage, guanine nitration, etc., which
may then bring about not only cytotoxic effect but
also mutagenesis. Numbers of evidence in vitro and
in vivo show that treatment with chemical
carcinogens such as carbon tetrachloride and
heterocyclic amines also generated superoxide. The
chronic inflammatory reactions, e.g., zymosan- and
silica-induced granuloma, revealed very similar free
radical generation in vivo. In addition, most
experimental solid tumors have elevated levels of
iNOS in the tumor tissue, and NO thus generated
facilitates vascular permeability, which accelerates
nutritional supply to the tumor tissue and hence
sustains the rapid tumor growth. These
circumstantial evidences suggest that inflammatory
responses induced by various pathogens would
accelerate mutagenesis as well as tissue damage,
whereas NO also sustains more effectively solid
tumor growth when normal cells are transformed to
tumor or carcinoma cells by the host-derived free
radical species.
- Language of Publication
- English
- Unique Identifier
- 98389874
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- MeSH Heading (Major)
- Infection|CO/*ME; Inflammation|CO/*ME;
Neoplasms|ET/*ME; Nitric Oxide|*ME; Reactive Oxygen
Species|*ME
- MeSH Heading
- Animal; Bacterial Infections|CO/ME; Free
Radicals|ME; Human; Mice; Nitrates|ME; Nitric-Oxide
Synthase|ME; Superoxides|ME; Support, Non-U.S.
Gov't; Virus Diseases|CO/ME
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
- ISSN
- 0006-2979
- Country of Publication
- RUSSIA
Record 83 from database: MEDLINE
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- Title
- Prognostic implications of age in breast cancer
patients treated with tumorectomy and irradiation or
with mastectomy.
- Author
- Matthews RH; McNeese MD; Montague ED; Oswald MJ
- Address
- Department of Clinical Radiotherapy, University of
Texas M. D. Anderson Hospital and Tumor Institute,
Houston 77030.
- Source
- Int J Radiat Oncol Biol Phys, 1988 Apr, 14:4,
659-63
- Abstract
- Conservation breast treatment is of particular
interest to young women, but whether saving the
breast carries a penalty in shorter survival or
local-regional recurrent disease has not been
well-established. At The University of Texas M.D.
Anderson Hospital and Tumor Institute at Houston,
1161 patients treated prior to 1983 with Stage I or
II breast cancer were reviewed. Of these patients,
378 were treated with tumorectomy plus irradiation,
and 783 were treated with radical or modified
radical mastectomy. The two patient groups were
compared relative to local-regional disease
recurrence and overall and disease-free survivals.
Local recurrences in the breast appear to be more
frequent in patients less than or equal to 35 years
of age treated with tumorectomy and irradiation than
in patients older than 35 years, but in patients
aged less than or equal to 50 or greater than 50 or
less than or equal to 35 or greater than 35 years,
there was no significant statistical difference
between tumorectomy and irradiation or mastectomy
nor was there a difference in disease-free survival.
Overall survival rates favored patients treated by
tumorectomy and irradiation.
- Language of Publication
- English
- Unique Identifier
- 88169258
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- MeSH Heading (Major)
- Breast Neoplasms|PA/RT/*SU
- MeSH Heading
- Adult; Age Factors; Case Report; Female; Follow-Up
Studies; Human; Lymphatic Metastasis; Mastectomy;
Middle Age; Neoplasm Staging; Prognosis; Support,
Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0360-3016
- Country of Publication
- UNITED STATES
Record 84 from database: MEDLINE
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- Title
- Primary squamous cell cancer of the vulva: radical
versus modified radical vulvar surgery.
- Author
- Magrina JF; Gonzalez Bosquet J; Weaver AL; Gaffey
TA; Webb MJ; Podratz KC; Cornella JL
- Address
- Department of Obstetrics and Gynecology, Mayo
Clinic Scottsdale, Scottsdale, Arizona 85259, USA.
- Source
- Gynecol Oncol, 1998 Oct, 71:1, 116-21
- Abstract
- OBJECTIVE: To evaluate the results of surgical
therapy and to specifically compare radical and
modified radical vulvar surgery relative to
survival, recurrence, metastasis, and complications.
METHODS: A retrospective review of 225 patients with
primary squamous cell cancer of the vulva was
performed. Clinical, pathologic, surgical, and
follow-up data were collected from the patient
records. All pathology slides were reviewed with a
pathologist. Radical surgery included 134 patients
treated by the Basset operation. Modified radical
surgery accounted for 91 patients with vulvar
excision alone (65) or with lymphadenectomy (26) via
separate groin incisions. RESULTS: The 5-year
recurrence rate was 14%. The overall and
disease-free survival rates at 5 years were 76. 1
and 83.4%, respectively. There were no statistically
significant differences between the two procedures
regarding overall survival, disease-free survival,
or the development of recurrence, even after
adjusting for stage (P > 0.05). Patients
undergoing radical vulvar surgery were more likely
to develop surgical complications and sequelae than
patients having modified radical surgery, even after
adjusting for stage. CONCLUSIONS: Modified radical
vulvar surgery is associated with decreased
complications and 5-year overall and disease-free
survival and recurrence rates similar to those of
radical vulvar surgery. Copyright 1998 Academic
Press.
- Language of Publication
- English
- Unique Identifier
- 99003101
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- MeSH Heading (Major)
- Carcinoma, Squamous Cell|MO/*SU; Surgical
Procedures, Operative|AE/*MT; Vulvar Neoplasms|MO/*SU
- MeSH Heading
- Adult; Aged; Aged, 80 and over; Comparative Study;
Female; Human; Middle Age; Neoplasm Metastasis;
Neoplasm Recurrence, Local|EP; Postoperative
Complications; Retrospective Studies; Survival Rate
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0090-8258
- Country of Publication
- UNITED STATES
Record 85 from database: MEDLINE
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- Title
- Dermal graft for protection of the pharyngeal
suture line in cancer surgery of the head and neck.
- Author
- Koltai PJ; Leipzig B
- Address
-
- Source
- Otolaryngol Head Neck Surg, 1981 Mar, 89:2, 260-3
- Abstract
- We studied the effect of free buried dermal grafts
to primary pharyngeal closures among 24
nonirradiated patients undergoing radical head and
neck surgery to determine if this technique would
reduce the incidence of postoperative
pharyngocutaneous fistula. For a control group we
selected 23 patients who had undergone similar
operations as the patients in the study group, but
who did not have dermis used for pharyngeal
protection. Our results indicate that dermal grafts
do not alter the incidence of fistulization
following cancer surgery of the head and neck.
- Language of Publication
- English
- Unique Identifier
- 81222308
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- MeSH Heading (Major)
- Carcinoma, Squamous Cell|*SU; Head and Neck
Neoplasms|*SU; Pharyngeal Neoplasms|*SU; Skin|*TR;
Skin Transplantation|*
- MeSH Heading
- Fistula|PC; Human; Laryngeal Neoplasms|SU; Mouth
Neoplasms|SU; Pharyngeal Diseases|PC; Postoperative
Complications|PC; Skin Diseases|PC; Transplantation,
Autologous
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0194-5998
- Country of Publication
- UNITED STATES
Record 86 from database: MEDLINE
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- Title
- Carcinoembryonic antigen and prognosis after
radical surgery for lung cancer: immunocytochemical
localization and serum levels.
- Author
- Ford CH; Stokes HJ; Newman CE
- Address
-
- Source
- Br J Cancer, 1981 Aug, 44:2, 145-53
- Abstract
- Eighty-two per cent of tumour sections from 105
patients with lung cancer showed positive
immunocytochemical localization of an anti-carcinoembryonic
antigen (CEA) immunoglobulin free of antibody to
normal cross-reacting antigen (NCA). The highest
incidence was found in adenocarcinomas, and no
association between staining and disease stage was
found. There was a relationship between
positive-staining tumours and preoperative and
postoperative serum CEA levels of greater than or
equal to 20 ng/ml, but the high incidence of CEA+,
less than 20 ng/ml serum patients indicated that
immunocytochemical localization was of little value
in selecting patients for sequential serum
monitoring. Staining for CEA was not prognostic but
a preoperative serum CEA levels greater than or
equal to 20 ng/ml was associated with a poor
prognosis in patients undergoing radical surgery for
lung cancer (P = 0.043). this prognostic effect of
CEA was seen mainly in patients whose tumours showed
the greatest immunocytochemical localization (P =
0.017) and in Stage III patients (P = 0.04).
- Language of Publication
- English
- Unique Identifier
- 82000316
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- MeSH Heading (Major)
- Carcinoembryonic Antigen|*AN; Lung Neoplasms|*IM/MO/SU
- MeSH Heading
- Human; Immunoenzyme Techniques; Prognosis;
Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0007-0920
- Country of Publication
- ENGLAND
Record 87 from database: MEDLINE
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- Title
- Influence of the timing of physiotherapy upon the
lymphatic complications of axillary dissection for
breast cancer.
- Author
- Rodier JF; Gadonneix P; Dauplat J; Issert B;
Giraud B
- Address
- Centre Jean Perrin, Clermont-Ferrand, France.
- Source
- Int Surg, 1987 Jul, 72:3, 166-9
- Abstract
- A prospective randomized study was carried out to
discover the influence of the timing of shoulder
physiotherapy after-axillary dissection for breast
cancer upon the incidence and duration of lymphatic
fluid production and seroma after these operations.
Sixty-eight patients underwent a modified radical
mastectomy, 31 were submitted to early physiotherapy
and 37 to delayed physiotherapy after removal of the
suction drainage. In 32 patients this surgery was
conservative of the breast; in 16 the physiotherapy
was early and in 16 delayed. The shoulder was left
free when the physiotherapy was delayed. The mean
volume of lymphatic fluid produced after these 100
axillary dissections was 437 cc (range: 50 to 800
cc) with a mean duration of 6.3 days (range: 2 to 11
days). There was a linear relation between the
volume and the duration of the lymphatic fluid
production. This volume was significantly higher in
radical mastectomy than in conservative procedures
(486 cc vs 333 cc - p less than 0.02). There was no
significant difference in the production of
lymphatic fluid with early or delayed physiotherapy,
whatever the group of patients: radical or
conservative surgery - age - number of excised lymph
nodes - lymph node involvement. Five seromas
occurred in patients with delayed physiotherapy.
Delaying physiotherapy after axillary dissection for
breast cancer does not seem to reduce the incidence
of lymphatic complication, but the use of a
conservative procedure rather than a modified
radical mastectomy seems to be able to do so.
- Language of Publication
- English
- Unique Identifier
- 88057985
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- MeSH Heading (Major)
- Breast Neoplasms|RH/*SU; Lymph Node Excision|*;
Mastectomy|AE/MT/*RH; Physical Therapy|*
- MeSH Heading
- Adult; Aged; Axilla; Female; Human; Lymph|SE;
Middle Age; Prospective Studies; Time Factors
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED
CONTROLLED TRIAL
- ISSN
- 0020-8868
- Country of Publication
- UNITED STATES
Record 88 from database: MEDLINE
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- Title
- The association of body weight with recurrent
cancer of the breast.
- Author
- Donegan WL; Hartz AJ; Rimm AA
- Address
-
- Source
- Cancer, 1978 Apr, 41:4, 1590-4
- Abstract
- Recurrence of carcinoma of the breast after
radical mastectomy was associated with preoperative
body weight among patients observed for up to 24
years. Patients who had no axillary lymph node
metastases and who weighed 130 pounds or less had an
accumulative recurrence free survival superior to
that of heavier patients. The advantage was
unassociated with significant differences in
menopausal status, clinical stage, or tumor size.
High fat diet and large body mass have been linked
epidemiologically with high risk for breast cancer;
whatever biologic mechanisms are involved may also
promote growth of residual tumor after potentially
curative surgery. Diet and weight reduction may
represent empirical means for improving the
prognosis of heavy individuals with early stages of
breast cancer.
- Language of Publication
- English
- Unique Identifier
- 78146286
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- MeSH Heading (Major)
- Body Weight|*; Breast Neoplasms|EP/*ET/PA
- MeSH Heading
- Epidemiologic Methods; Female; Human; Lymphatic
Metastasis; Missouri; Recurrence; Risk
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-543X
- Country of Publication
- UNITED STATES
Record 89 from database: MEDLINE
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- Title
- Combined modality treatment of locally advanced
breast cancer: adjuvant combination chemotherapy
with and without doxorubicin.
- Author
- Casper ES; Guidera CA; Bosl GJ; Hakes TB; Kaufman
RJ; Shurgot B; Kinne DW
- Address
-
- Source
- Breast Cancer Res Treat, 1987, 9:1, 39-44
- Abstract
- Forty-one women with non-metastatic but locally
advanced breast cancer were treated by modified
radical or radical mastectomy, and were then
randomized to receive one of two adjuvant
chemotherapy regimens. Regimen A consisted of 6
months of cyclophosphamide, adriamycin, and
fluorouracil (CAF) followed by 6 months of
cyclophosphamide, methotrexate, fluorouracil,
vincristine, and prednisone (CMFVP). Regimen B was
12 months of CMFVP. Patients were stratified for
estrogen-receptor status, and all patients with a
positive estrogen receptor value received tamoxifen
20 mg bid in addition to the chemotherapy. Eight of
21 patients randomized to Regimen A are alive and
free of disease, whereas only 1 of 20 patients on
Regimen B is well. A trend toward improved
disease-free survival favoring Regimen A was
observed (P = .05), although a significant
difference in overall survival has not been
demonstrated. Our findings support the continued
study of adriamycin-containing regimens in the
adjuvant setting and in combined modality therapy of
locally advanced breast cancer.
- Language of Publication
- English
- Unique Identifier
- 87243002
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- MeSH Heading (Major)
- Antineoplastic Agents, Combined|AE/*TU; Breast
Neoplasms|MO/*TH; Doxorubicin|*AD
- MeSH Heading
- Adult; Aged; Combined Modality Therapy;
Cyclophosphamide|TU; Female; Fluorouracil|TU; Human;
Methotrexate|TU; Middle Age; Support, U.S. Gov't,
P.H.S.
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED
CONTROLLED TRIAL
- ISSN
- 0167-6806
- Country of Publication
- NETHERLANDS
Record 90 from database: MEDLINE
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- Title
- Carcinoembryonic antigen (CEA) in the follow-up of
disease-free breast cancer patients.
- Author
- Veronesi A; Talamini R; Longhi S; Crivellari D;
Galligioni E; Tirelli U; Trovò MG; Magri MD;
Frustaci S; Figoli F; Zagonel V; Tumolo S;
Grigoletto E
- Address
-
- Source
- Tumori, 1982 Dec, 68:6, 477-80
- Abstract
- Carcinoembryonic antigen (CEA) assays (2536) were
performed in 380 disease-free breast cancer patients
after radical mastectomy. In the 334 evaluable
patients with 3 or more determinations, the overall
relapse rate after a median follow-up of 29 months
was 11%. Of 203 patients with normal CEA values, 19
(9.3%) relapsed. In the 50 patients with the highest
CEA value greater than 20 ng/ml, the relapse rate
was 26%; in the 12 patients with gradually
increasing CEA elevations it was 50%. However, CEA
was unable to predict recurrence in N- patients.
Premastectomy N+ was significantly associated with
greater than 20 ng/ml or gradually increasing CEA
values, suggesting the lack of an independent
prognostic value of CEA in our patient population.
- Language of Publication
- English
- Unique Identifier
- 83173017
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- MeSH Heading (Major)
- Breast Neoplasms|*IM/SU; Carcinoembryonic
Antigen|*AN
- MeSH Heading
- Female; Follow-Up Studies; Human; Lymphatic
Metastasis; Mastectomy; Neoplasm Recurrence, Local
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0300-8916
- Country of Publication
- ITALY
Record 91 from database: MEDLINE
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- Title
- Adjuvant chemotherapy in males with cancer of
the breast.
- Author
- Bagley CS; Wesley MN; Young RC; Lippman ME
- Address
-
- Source
- Am J Clin Oncol, 1987 Feb, 10:1, 55-60
- Abstract
- Analysis of recurrence rates in male breast
cancer (MBC) has suggested that tumor size and
degree of axillary lymph node involvement carry
the same prognostic implications as for breast
cancer in women. A similar spectrum of
antineoplastic agents appears active in both
females and males. Based on reports of active
adjuvant chemotherapy of women with breast cancer,
we initiated a trial of adjuvant chemotherapy of
MBC in July 1974. Twenty-four patients have been
treated with cyclophosphamide, methotrexate, and
5-fluorouracil (CMF). All patients had nodal
involvement (median three nodes positive; seven
patients had a single positive lymph node). All
patients began adjuvant therapy within 4 weeks of
either a radical or modified radical mastectomy.
No postoperative radiotherapy was given. Median
potential follow-up is 46 months. Four patients
have recurred, one each at 15, 45, 61, and 65
months following mastectomy; two are dead of
metastatic disease. The five-year survival rate
projected by actuarial means is in excess of 80%
(95% confidence interval: 74-100%). Based on these
data, this treatment is highly encouraging when
compared to other forms of treatment reported in
the literature in which 5-year disease-free
survival rates are less than 30%. We conclude that
adjuvant therapy of MBC with a CMF regimen is
feasible and may be associated with substantial
improvement in disease-free survival and overall
survival.
- Language of Publication
- English
- Unique Identifier
- 87153205
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- MeSH Heading (Major)
- Antineoplastic Agents, Combined|*TU; Breast
Neoplasms|*DT/MO/PA
- MeSH Heading
- Aged; Combined Modality Therapy;
Cyclophosphamide|AE/TU; Fluorouracil|AE/TU; Human;
Male; Methotrexate|AE/TU; Middle Age; Neoplasm
Staging
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0277-3732
- Country of Publication
- UNITED STATES
Record 92 from database: MEDLINE
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- Title
- A case of pancreatoduodenectomy as resolutive
treatment for a solitary metastasis of breast
cancer.
- Author
- Azzarelli A; Clemente C; Quagliuolo V; Baticci F
- Address
-
- Source
- Tumori, 1982 Aug, 68:4, 331-5
- Abstract
- A 49-year-old woman was hospitalized for
obstructive jaundice 4 years after extended
mastectomy for lobular infiltrating carcinoma.
After routine investigations that detected a
malignant lesion of the pancreas head, the patient
underwent pancreatoduodenectomy. The surgical
specimen revealed unexpected breast carcinoma
metastatic to the pancreas and duodenum wall. The
woman is alive and free of disease at 10 years
from the mastectomy and 6 years from the
pancreatoduodenectomy. This experience confirms
the validity of a surgical radical treatment for
metastatic lesions in selected cases.
- Language of Publication
- English
- Unique Identifier
- 83068678
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- MeSH Heading (Major)
- Breast Neoplasms|*/SU; Carcinoma|*SC/SU;
Duodenal Neoplasms|*SC/SU; Duodenum|*SU;
Pancreatectomy|*; Pancreatic Neoplasms|*SC/SU
- MeSH Heading
- Case Report; Cholestasis|ET; Female; Human;
Mastectomy; Mesenteric Arteries|RA; Middle Age;
Postoperative Period
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0300-8916
- Country of Publication
- ITALY
Record 93 from database: MEDLINE
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- Title
- Conservative treatment of axillary adenopathy
due to probable subclinical breast cancer.
- Author
- Vilcoq JR; Calle R; Ferme F; Veith F
- Address
-
- Source
- Arch Surg, 1982 Sep, 117:9, 1136-8
- Abstract
- Eleven female patients were treated
conservatively by radical radiotherapy to the
breast and ipsilateral lymphatics for metastatic
adenocarcinoma in an axillary lymph node without
clinical or mammographic evidence of a breast
cancer. Ten of 11, four of five, and three of four
were alive and free of disease 5, 10, and 15 years
later, respectively. Of the 11 patients who were
followed up for a minimum of five years, three
(27%) had local recurrences: one at six, one at
11, and one at 14 years. The latter two
recurrences were salvaged by secondary mastectomy.
The cosmetic results were excellent and no serious
irradiation complications were observed.
Mastectomy may not be needed for patients with
axillary adenopathy due to a probable subclinical
breast cancer, since the long-term prognosis after
radiotherapy is good and salvage surgery can be
performed if recurrences develop.
- Language of Publication
- English
- Unique Identifier
- 82283237
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- MeSH Heading (Major)
- Adenocarcinoma|*RT/SC; Breast Neoplasms|*;
Lymphatic Diseases|*RT
- MeSH Heading
- Adult; Aged; Axilla; Female; Human; Lymphatic
Metastasis; Middle Age; Neoplasm Recurrence,
Local; Neoplasms|RT/SC; Prognosis; Retrospective
Studies
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0004-0010
- Country of Publication
- UNITED STATES
Record 94 from database: MEDLINE
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- Title
- Nonobesity at the time of mastectomy is highly
predictive of 10-year disease-free survival in
women with breast cancer.
- Author
- Zumoff B; Gorzynski JG; Katz JL; Weiner H; Levin
J; Holland J; Fukushima DK
- Address
-
- Source
- Anticancer Res, 1982 Jan, 2:1-2, 59-62
- Abstract
- 25 unselected women with operable breast cancer
were followed after radical mastectomy until they
died of recurrent cancer (non-survivors), or for
10 years if there was no recurrence (survivors):
all the women still alive at 10 years were
clinically and radiographically disease-free.
Survivors and non-survivors were compared with
respect to premastectomy height, and deviation
from ideal weight. There were 16 women in the
survivor group; at the time of mastectomy, they
averaged 11% above ideal weight and only 4 of them
(25%) were obese (20% or more above ideal weight).
There were 9 women in the non-survival group; they
averaged 51% above ideal weight at the time of
mastectomy and all of them were obese, as defined.
The intergroup difference in mean deviation from
ideal weight was very highly significant (P less
than 0.0001). Of the 13 women who were obese at
mastectomy, only 4 (31%) became survivors, while
100% of the 12 women who were non-obese at
mastectomy became survivors; the difference in
percent survival was very highly significant (P
less than 0.005). Separate evaluation of the roles
of height and weight showed that height was not a
factor and weight accounted entirely for the
observed differences. It appears that maintenance
of nonobesity may be a more effective way of
decreasing mortality from breast cancer than any
other measure proposed to date.
- Language of Publication
- English
- Unique Identifier
- 82282626
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- MeSH Heading (Major)
- Breast Neoplasms|CO/*MO/SU; Mastectomy|*;
Obesity|*CO
- MeSH Heading
- Adult; Aged; Body Weight; Female; Follow-Up
Studies; Human; Middle Age; Neoplasm Recurrence,
Local|MO; Prognosis; Support, Non-U.S. Gov't;
Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0250-7005
- Country of Publication
- GREECE
Record 95 from database: MEDLINE
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- Title
- Chemical modulation of the hypoxic fraction in
the treatment of head and neck cancer.
- Author
- Weichselbaum RR; Ervin TJ; Miller D
- Address
-
- Source
- Ann Otol Rhinol Laryngol, 1982 Jul, 91:4 Pt 1,
461-4
- Abstract
- Treatment of large squamous carcinomas of the
head and neck often requires intensive of
multidisciplinary treatment. Despite such
aggressive measures, local recurrence is common.
Possible reasons for such local failure are
numerous. Hypoxic but viable tumor cells may be
one means of resistance to radiotherapy and
chemotherapy. If surgical removal cannot eliminate
these cells, tumor regrowth may occur. Modulation
of the hypoxic fraction is one means of
potentially altering resistance to radiotherapy.
Misonidazole, a radiosensitizer, has been thought
to increase free radical formation in hypoxic
cells in vitro thus increasing the
radiosensitivity. This observation is discussed
with reference to advanced head and neck cancer.
- Language of Publication
- English
- Unique Identifier
- 82282502
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- MeSH Heading (Major)
- Carcinoma, Squamous Cell|*DT/RT; Head and Neck
Neoplasms|*DT/RT; Oxygen|*PH
- MeSH Heading
- Animal; Cell Survival|DE/RE; Gamma Rays; Human;
Methotrexate|TU; Misonidazole|PD; Radiation
Tolerance; Rats
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0003-4898
- Country of Publication
- UNITED STATES
Record 96 from database: MEDLINE
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