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Biomedical subjects

C R Smart

Publications and source records attributed to C R Smart.

At least 55 records · Page 3Linked to original sources

Management and survival of adenocarcinoma of the rectum in the United States: results of a national survey by the American College of Surgeons.

Data from the long- and short-term surveys of the American College of Surgeons Commission on Cancer were examined to evaluate the survival and management of patients with rectal cancer in the United States. Overall, females experienced better survival than males, and white had better survival than blacks. The 5-year survival rates for localized, regional and distant stages of the disease were 76.4, 43.1, and 5.5% respectively. The survival rates in relation to histologic grade of the tumor indicated that the survival experiences of patients with well and moderately differentiated tumors were similar (57% versus 54%) and that patients with poorly differentiated tumors had significantly lower survival (35%). The survival experience of those receiving abdominoperineal resection was similar to those treated by low anterior resection (56% versus 58%). Location of the tumor in the rectum did not affect prognosis.

Adenocarcinoma↗

Trends in the United States for the management of adenocarcinoma of the rectum.

Data from surveys conducted by the Commission on Cancer of the American College of Surgeons were examined to identify recent trends in the treatment of carcinoma of the rectum. Between 1973 and 1978, the stage of disease at diagnosis for the total series changed little, but significant upgrading in the stage of disease at diagnosis for the black patients was observed. There was increasing use of a multimodality approach to treatment combining operation with radiotherapy. The use of chemotherapy alone or in combination with other therapies, while never widely used, declined during the interval observed. Significant changes occurred in the type of operations performed for carcinoma in the upper two-thirds of the rectum. During this interval, abdominoperineal resection was increasingly being displaced by low anterior resection. The trend toward multimodality treatment and the use of effective sphincter preserving procedures represent significant changes noted in this survey in the therapy of carcinoma of the rectum.

Adenocarcinoma↗

Breast cancer and reproductive history from genealogical data.

With the use of data from the Utah State Cancer Registry and Utah genealogical data, an analysis of 236 breast cancer patients and 937 controls matched on year of birth showed that a late age at the birth of the first child was most strongly associated with incidence of breast cancer (relative odds = 2.0; P less than 0.001). A strong interaction was found between age at first delivery (AFD) and age at last delivery (ALD). The association of AFD with breast cancer incidence was strongest for women with an ALD before 35 years of age even after adjustment for partly (relative odds = 4.1; P less than 0.001). Decreased parity was not significantly associated with breast cancer.

Adult↗

Diagnosis of minimal breast cancers in the BCDDP: the 66 questionable cases.

Of 1,810 breast cancers detected in the NCI/ACS Breast Cancer Detection Demonstration Projects, 592 were less than 1 cm in diameter and considered minimal; and tissue slides from 506 of them were available for retrospective review by a panel of pathologists. The initial report of this review indicated that in 66 cases the pathologic features of the presented slides were not sufficient for diagnosis of cancer. Subsequent investigation revealed that, through computer error, the slides submitted in 2 of these 66 cases were not from the lesions in question but from blind biopsy of the contralateral breast. Further review by the pathology panel of tissue from 38 of the 64 remaining cases determined that 16 of the remaining lesions were indeed cancers or borderline malignant lesions. This then left 48 cases in doubt. Only biopsy had been performed in 11 of them, and some form of mastectomy in the other 37. The original pathologic opinion had been divided in 30 of these, and the mastectomy had been delayed for 1 day to 7 months after the biopsy. In only 7 of the 48 questionable cases was definitive treatment carried out at the time of biopsy. All in all, these findings reflect sound, responsible surgical judgment.

Breast Neoplasms↗

The effect of anticancer therapy on peripheral blood T and B lymphocyte counts and function.

Patients categorized according to tumor type were compared to a control non-tumor population. Comparison of relative T cell values among the groups showed no significant differences; however, when absolute numbers of T cells/mm3 were compared, all cancer patients, whether from treated or untreated groups, had significantly depressed T cell values. No significant differences were observed in the relative or absolute numbers of B cells. Comparison of the total lymphocyte response to PHA showed no significant differences among the various cancer groups; however, response in all cancer groups whether from treated or untreated patients, was depressed by comparison to the control group. Patients categorized according to the type of treatment received showed significant depression in the white blood count, lymphocyte count, relative and absolute T cell counts and the absolute B cell count in the postsurgery, postadjunctive therapy group. The pretherapy group also showed significant depression in the absolute number of T cells/mm3 when compared to the controls. Response to PHA correlated with the absolute T cells values.

Antineoplastic Agents↗

Implications from SEER data on breast cancer management.

From the SEER files of the NCI, 8,587 cases of breast cancer diagnosed in 1975 were analyzed. Of these cases, 5.3% were noninvasive. Of the invasive cancers under 0.5 cm in diameter, 17.2% had positive axillary lymph nodes. Where the physician recorded no palpable axillary lymph nodes, 34.5% were found to be positive.

Axilla↗

Low cancer incidence and mortality in Utah.

Utah cancer mortality for the years 1950-1969 and morbidity for the years 1966-1970 are reported. Utah had 18% fewer cases of cancer than expected based on the Third National Cancer Survey, and 24% fewer cancer deaths than expected based on national mortality data. Cancer sites associated with cigarette smoking and alcohol use accounted for nearly half of these differences. Several major sites not strongly associated with smoking showed lower incidence and mortality than expected. These included pancreas, colon, rectum, female breast, uterine cervix and ovary. A marked excess occurrence above expectation was observed for cancer of the lip. Some possible explanations of these findings are discussed, including some of the unique aspects of the Utah population.

Adolescent↗

Estimated median survival times of patients with colorectal cancer based on experience with 9,745 patients.

From the End Results Group file at the National Cancer Institute, 9,745 colorectal cancer patients diagnosed from 1965 through 1971 and classified as adenocarcinoma NOS were selected to evaluate the joint effect of various prognostic factors on MST. A technic was developed which enables a physician to estimate the MST for a patient with a given set of patient/disease characteristics. The results are also summarized in an appendix, allowing the physician to bypass the calculation and refer directly to the MST. These results will aid the physician in determining whether a patient is at sufficiently high risk to warrant adjuvant therapy. The survival experience of this broad historical group of patients with varying prognostic factors can also serve as a basis for comparison of results of studies on highly selected patients treated in various experimental ways.

Adenocarcinoma↗

Cancer incidence in Mormons and non-Mormons in Utah, 1966-1970.

Between 1950 and 1969 cancer mortality in white Utah residents was 22 per cent less than that in the entire United States population. The religion of 72 per cent of the State residents (Mormon) proscribes use of tobacco and alcohol. We therefore analyzed the 10,641 cases of cancer identified in Utah from 1966 to 1970 and compared the incidence found in Utah Mormons, in Utah non-Mormons, and in a national survey. Comparison of Utah Mormons with non-Mormons showed that Mormons had a lower incidence of all cancers associated with cigarette smoking (P less than 0.00001). Mormon females had a low incidence of cancer of the breast (P = 0.008), uterine cervix (P less than 0.00001), and ovary (P = 0.04); Mormon males had a lower incidence of stomach cancers (P = 0.003). These findings addevidence to the association between cigarette smoking and certain cancers, but leave unexplained the significant differences between Mormons and non-Mormons for incidence of cancer of the breast, cervix, prostate and nervous system.

Alcohol Drinking↗