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Biomedical subjects

C M Sutherland

Publications and source records attributed to C M Sutherland.

At least 37 records · Page 2Linked to original sources
PubMed1988

Breast neoplasms: duplex sonographic imaging as an adjunct in diagnosis.

Sonographic breast imaging has been useful in the differentiation of cystic from solid masses. It has also been helpful in the characterization of palpable breast masses in the absence of corresponding abnormalities. The authors undertook a prospective study that incorporated pulsed Doppler analysis into sonographic real-time imaging of solid breast masses. Thirty-eight patients were examined. In 12 of the patients there were positive Doppler signals, while in 26 patients there were no Doppler signals. The 12 patients showing positive Doppler signals proved to have infiltrating ductal carcinoma, while the 26 patients with negative Doppler signals proved to have benign breast disorders. Pulsed Doppler analysis as a supplement to sonographic real-time imaging shows promise for the identification of breast carcinoma.

Adult↗
PubMed1987

Chemotherapy by regional perfusion for limb melanoma.

The administration of chemotherapy by isolated regional perfusion was developed in 1957 at Tulane University and was found to be of greatest benefit for patient with melanoma of the limbs. From 1957 to 1984, 897 patients were treated by this method. The 10-year survival rate for 831 patients with primary melanoma was 77 per cent. Women survived longer than men, with 10-year rates of 81 per cent and 65 per cent, respectively. Prophylactic lymph node dissection was of benefit for males with poor prognosis distal lower limb lesions, but other groups did not benefit. Primary lesions on the arm and thigh did better than lesions of the hand or foot, with plantar and subungual lesions having the least favorable results. Thickness, level, and histologic type were also significant prognostic indicators. Thirty-three patients with locally recurrent melanoma (stage II) treated by perfusion and excision had a 10-year survival rate of 59 per cent. For 129 patients with metastases to the regional lymph nodes (IIIB), perfusion plus RLND produced a 10-year rate of 51 per cent; survival rates for those with a single positive node was 64 per cent. Seventy patients with satellitosis or intransit metastases (IIIA) had a 10-year survival rate of 23 per cent. Thirty-eight patients with metastases to limbs from unknown primaries had a 10-year survival rate of 52 per cent. The overall 10-year rate for all stage III patients was 41 per cent. Perfusion produced useful palliation in 144 patients with limb melanoma in the presence of systemic metastases.

Chemotherapy, Cancer, Regional Perfusion↗
PubMed1987

Factors influencing the survival of patients with regional melanoma of the extremity treated by perfusion.

Patients with regional metastases of malignant melanoma (75 with Stage IIIA soft tissue metastases, 124 with Stage IIIB nodal metastases and 75 with Stage IIIAB soft tissue and nodal metastases) treated by regional perfusion between 1957 and 1982 were retrospectively studied to identify prognostic factors relating to survival. In patients with Stage IIIB disease, the melanoma specific cumulative survival rates at five years was 72 per cent for one, 33 per cent for two to three and 20 per cent for four or more positive lymph nodes. In patients with Stage IIIAB disease, those with one node had a better survival rate at five years than those with multiple nodes (45 versus 25 per cent). In patients with Stage IIIA melanoma, two groups were identified based upon the results of prior treatment--those with and without prophylactic lymph node dissection (PLND) at the time of primary therapy. The factors associated with decreased survival rates in patients with PLND were: 1, increasing age; 2, presence of subcutaneous or both subcutaneous and dermal metastases, and 3, treatment at normothermic temperatures or earlier date of treatment. No significant factors were found in the group without PLND; however, the survival time was similar to that for patients with Stage IIIAB and one positive node (45 per cent at five years). Knowledge of these factors is important in assessing the prognosis and establishing randomization criteria for prospective studies evaluating various forms of therapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Long-term survival and prognostic factors in breast cancer patients with localized (no skin, muscle, or chest wall attachment) disease with and without positive lymph nodes.

Uncertainty exists regarding the magnitude of excess mortality from localized breast cancer at long follow-up times (greater than 15 years) since diagnosis and regarding the effects of race and age as prognostic factors at all follow-up times. Long-term survival was determined in 1141 patients (311 white, 830 black) diagnosed as having localized breast cancer with and without positive axillary lymph nodes, but without any signs of complete or incomplete skin, muscle, or chest wall attachment. Survival curves were estimated by means of actuarial methods; prognostic factors were evaluated with the Cox's regression analysis. Survival from all causes was 62%, 43%, 33%, 25%, and 18% at 5, 10, 15, 20, and 30 years, respectively. Breast cancer-specific survival was 76%, 65%, 63%, 61%, and 59% at 5, 10, 15, 20, and 30 years, respectively. Breast cancer-specific hazard rates exceeded those expected in the general population by 119 times, 53 times, 12 times, and 6 times at 0 to 5, 5 to 10, 10 to 20, and 20 to 25 years, respectively. Of the 395 patients enrolled after 1968 who had modified radical or radical surgery, 338 had known number of positive nodes and size of tumor. Breast cancer-specific survival was significantly increased with: a decreasing number of positive lymph nodes, 0, 1 to 3, and 4 or more (P = 0.000); later year of diagnosis (1974 or before versus 1975 or later) (P = 0.000); and possibly, tumor size of 7.0 cm or less (P = 0.09). When these variables were controlled, no significant association of age at diagnosis or race with breast cancer-specific survival was found. These data suggest that the number of nodes, year of diagnosis and, possibly, tumor size are important prognostic factors for survival, but race and age are not. Also, excess mortality may exist at late intervals; however, it is small in relation to other causes.

Adult↗
PubMed1986

Isolated perfusion of extremities for metastatic melanoma from an unknown primary lesion.

Since 1957, 822 patients with invasive malignant melanoma of the limbs were treated by regional perfusion at the Tulane Medical Center. Between 1958 and 1982, there were 32 patients with regional metastatic melanoma from an unknown primary site involving either the upper limb and axillary lymph nodes or lower limb and femoral or inguinal lymph nodes. This group represents 3.5% of patients with regional melanomas treated during this period. There were 16 patients with upper limb regional metastases and 14 patients with lower limb metastases. Sixteen patients had stage IIIB disease (ie, regional lymph node metastases), ten had stage IIIA disease (ie, satellitosis), and four had stage IIIAB disease. Six patients had a history of a suggestive limb lesion that had completely regressed and showed no residual tumor on biopsy. All 30 patients were treated by regional isolated perfusion and regional lymph node dissection, with surgical excision of in-transit disease when possible. The cumulative five-year survival for all patients is 50%. Interestingly, the patients with a history of a lesion that regressed had 85% cumulative five-year survival, and the patients with stage IIIB disease did almost as well, with 62% surviving for five years.

Adult↗
PubMed1985

Long-term survival and prognostic factors in patients with regional breast cancer (skin, muscle, and/or chest wall attachment).

Between 1948 and 1981, 1230 patients were diagnosed as having regional (skin, muscle, or chest wall attachment) breast cancer, and long-term survival was studied. In all patients, overall survival was 33% at 5 years, 19% at 10 years, and 9% at 20 years. Significant excess mortality due to breast cancer was observed throughout the 20-year follow-up period (P less than 0.002). The risk of breast cancer was highest in the 5-year period following diagnosis, and declined steadily from that time. Additionally, 308 patients diagnosed since 1968 were studied for the effect of prognostic factors. Clinical status of nodes (positive or negative) and presence or absence of peau d'orange were found to be significant prognostic factors in those patients. In those receiving radical surgery, the number of nodes and presence or absence of peau d'orange were found to be of prognostic significance. No effect of race, age, year of diagnosis, site of attachment, type of fixation, ulceration, edema, size of tumor, satellite nodules, or dimpling retraction on breast-cancer-specific survival was observed when the nodal status and peau d'orange were controlled. These data demonstrate that mortality in regional breast cancer is significant and is highly dependent on peau d'orange and nodal status.

Actuarial Analysis↗
PubMed1985

Response to aminoglutethimide after failure of tamoxifen therapy in breast cancer.

A 54-year-old woman had a primary breast cancer with an estrogen receptor of 11.9 fmoles/mg of protein. One year later bony metastases were treated with tamoxifen. The disease progressed rapidly, and therapy was changed to aminoglutethimide, which has resulted in an almost complete remission. This case shows that patients who fail to respond to tamoxifen therapy may have a good response to other endocrine manipulation--in this instance, aminoglutethimide.

Aminoglutethimide↗
PubMed1985

Breast cancer in a patient with prolactinoma.

Although the role of prolactin in the initiation and promotion of mammary carcinoma has been proved in animal experiments, a similar effect of hormone in the development of human mammary tumor has not been clearly demonstrated. If hyperprolactinemia is a significant factor in the initiation and promotion of human breast carcinoma, the incidence of mammary carcinoma in patients with hyperprolactinemia, with or without prolactinomas, might be higher than in control populations, but this relationship has never been documented. We present this case to stimulate awareness of the possibility so the condition will be investigated further.

Adult↗
PubMed1984

Effect of impaired renal function on tamoxifen.

There is no information available in the literature on the blood levels of tamoxifen in patients with decreased renal function. As serious side effects of tamoxifen administered at high doses have been reported, a patient with decreased renal function and metastatic breast cancer was studied to determine the blood levels of tamoxifen while under therapy. Since no abnormally elevated levels of tamoxifen were found in this patient during the month of therapy, results of this study indicate that tamoxifen can be administered to patients with some degree of renal impairment without the risk of giving rise to abnormally elevated blood levels.

Breast Neoplasms↗
PubMed1983

Serological detection of common human melanoma membrane antigens by microcomplement fixation and immunofluorescence.

An antiserum to human melanoma antigens was obtained from a melanoma patient after immunization with autologous irradiated cultured melanoma cells and bacillus Calmette-Guerin. Using the microcomplement fixation assay, the antiserum, at a titer of 1/1,800, was noted to bind strongly with 7 of 10 allogeneic cultured human melanoma cells lines. However, using the indirect immunofluorescence test and serum at a much lower titer (1/8), only 3 of the 10 melanoma cell lines were positive. Using both microcomplement fixation and indirect immunofluorescence, no significant reactivity was noted in several nonmelanoma cell lines including Hela, human lung adenocarcinoma, human prostatic carcinoma, WI-38 and VA-13 cell lines. These data suggest that common melanoma membrane antigens exist on 7 of 10 cultured human melanoma cell lines as tested by microcomplement fixation and that this assay is more sensitive than immunofluorescence. These common melanoma membrane antigens may eventually be extracted, purified and used for specific immunodiagnosis and immunotherapy.

Antigens, Neoplasm↗