|
NLM database Documents
Record 1 from database: MEDLINE
 Return
To Top
- 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
Return
To Top
- 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
Return
To Top
- 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
Return
To Top
- 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
Return
To Top
- 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
Return
To Top
- 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
Return
To Top
- 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
Return
To Top
- 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
Return
To Top
- 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
Return
To Top
- 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
Return
To Top
- 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
Return
To Top
- 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
Return
To Top
- 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
Return
To Top
- 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
Return
To Top
- 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
Return
To Top
Return
To Menu Position #10
- 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
Return
To Top
Return
To Menu Position #10
- 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
Return
To Top
Return
To Menu Position #10
- 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
Return
To Top
Return
To Menu Position #10
- 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
Return
To Top
Return
To Menu Position #10
- 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
Return
To Top
Return
To Menu Position #10
- 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
Return
To Top
Return
To Menu Position #10
- 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
Return
To Top
Return
To Menu Position #10
- 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
Return
To Top
Return
To Menu Position #10
- 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
Return
To Top
Return
To Menu Position #10
- 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
Return
To Top
Return
To Menu Position #10
- 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
Return
To Top
Return
To Menu Position #10
- 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
Return
To Top
Return
To Menu Position #10
- 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
Return
To Top
Return
To Menu Position #10
- 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
Return
To Top
Return
To Menu Position #10
- 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
Return
To Top
Return
To Menu Position #10
- 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
Return
To Top
Retu |
