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Biomedical subjects

D E Henson

Publications and source records attributed to D E Henson.

At least 55 records · Page 3Linked to original sources
PubMed1996

Unusual malignant epithelial tumors of the gallbladder.

Most malignant epithelial tumors of the gallbladder are heterogenous and classified as adenocarcinomas. The authors report a previously unrecognized group of unusual gallbladder carcinomas including two cases of signet ring cell carcinoma in situ, three of cribriform invasive adenocarcinoma, and one of adenocarcinoma with pseudoangiosarcomatous features. In addition, the authors review their material and update the information on clear cell, small cell, and undifferentiated carcinoma of the gallbladder. A new morphologic variant of undifferentiated carcinoma mimicking lobular carcinoma of the breast is identified. The clinical, morphologic, and immunohistochemical features of these unusual neoplasms are emphasized.

Adenocarcinoma↗
PubMed1995

Conditional survival of 56,268 patients with breast cancer.

BACKGROUND: Survival rates calculated from the date of diagnosis may not be predictive of future outcome for patients who have already survived several years after diagnosis. Conditional survival rates are more informative clinically because they take into account survival after diagnosis. METHODS: Conditional relative survival rates were calculated by the life-table method using data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. RESULTS: Survival rates up to 8 years for patients having survived 1, 2, 3, 4 or 5 years after diagnosis are presented by stage of disease for 56,268 women who were diagnosed as having invasive breast cancer from 1983 to 1987. CONCLUSIONS: Women with Stage IV breast cancer had a better survival as they moved further in time from their diagnosis. Survival rates did not improve for those with Stage I and II disease regardless of the number of years they survived after diagnosis.

Adult↗
PubMed1995

Liver, gallbladder, extrahepatic bile ducts, and pancreas.

BACKGROUND: The liver, gallbladder, bile ducts, and pancreas have a common embryologic origin; cancers that arise from these sites therefore are expected to share a similar spectrum of histologic types. These cancers are known for their extremely poor prognoses. METHODS: Data from the Surveillance, Epidemiology, and End Results Program regarding the incidence, distribution of histologic types, stage of disease, and survival for cancers of the gallbladder (n = 4412), extrahepatic bile ducts (n = 3486), pancreas (n = 23,116), and liver (n = 6,391) were reviewed. The most common histologic types are discussed, and the frequency of rare types is reported. RESULTS: The incidence of biliary cancer decreased, while the incidence of hepatic and pancreatic cancer rose slightly over the 15-year period from 1973 to 1987. Age and sex distributions varied by histologic type. Greater than 98% of pancreatic and biliary cancers were carcinomas, and adenocarcinoma (not otherwise specified) was the most common histologic type recorded. In the liver, hepatocellular carcinoma was the most common type, followed by intrahepatic cholangiocarcinoma. The overall 5-year relative survival rates for these cancers were very low: gallbladder, 12.3%; extrahepatic bile duct, 12.7%; liver 3.1%; and pancreas 2.5% (all stages combined, 1978-1986). CONCLUSIONS: This review confirmed that these carcinomas are associated with a very poor outcome; however, survival was influenced by stage of disease and histologic type. In the gallbladder and extrahepatic bile ducts, papillary adenocarcinoma was associated with the best outcome of all histologic types, and in the exocrine pancreas, mucinous cystadenocarcinoma was associated with the best prognosis.

Adolescent↗
PubMed1995

The histologic grading of cancer.

BACKGROUND: The histologic grade of a tumor provides prognostic information in addition to that provided by stage of disease. Poorly differentiated tumors are known to pursue a more aggressive course than their well differentiated counterparts. METHODS: The frequency of grading and the relationship of grade to outcome was investigated for 793,649 cases of cancer from 15 anatomic sites as recorded in the Surveillance, Epidemiology, and End Results Program. RESULTS: For all cancers, the frequency of grading increased from 1973 to 1987 and varied by anatomic site and histologic type. Survival decreased with advancing grade, and within each stage, grading separated cases into at least three distinct prognostic subgroups. For some cancers, regional stage cases assigned Grade 1 or 2 had higher survival rates than did localized stage cases assigned Grade 3 or 4. Therefore, grading allowed the identification of high and low risk subgroups within each stage grouping. CONCLUSIONS: The tumor grade was a strong prognostic indicator for cancers of the urinary bladder, endometrium, and prostate--sites most often graded by pathologists. The histologic grade was also an important determinant of outcome for cancers of the brain, soft tissue, and breast; however, only a small percentage of these tumors were graded. The results are important because no common criteria for grading were established among the many contributing pathologists. Therefore, observer variation did not alter the known relationship of histologic grade to outcome. This review demonstrates that the histologic grade is a strong predictor of outcome that refines the prognostic information provided by the stage of disease.

Female↗
PubMed1995

A national quality improvement effort: cancer registry data.

Cancer registries are sources of epidemiological, patterns-of-care, and outcome data for local, regional, state, and national studies of patients with cancer. Since 1976, these registries have formed a voluntary network of contributors to annual patient care studies under the aegis of the National Cancer Data Committee of the Commission on Cancer. These annual studies provide timely clinical information that is widely disseminated to physicians, allied health personnel, administrators, health care planners, and public and private agencies. The use of the data has grown exponentially and has been the basis for more than 90 publications. Merging this activity with the National Cancer Data Base has further expanded the demand and use of registry data. This study was undertaken to respond to inquiries as to the validity of the data and the qualifications and competency of cancer registrars. It provides the baseline for cancer registry data quality and serves as a quality management tool to identify opportunities to enhance data quality.

Databases, Factual↗
PubMed1995

Adenomyomatous hyperplasia of the gallbladder with perineural invasion.

We report three examples of either localized or segmental adenomyomatous hyperplasia of the gallbladder in association with cholelithiasis. Two patients were women, 58 and 81 years of age, and the third was a 62-year-old man. The finding of perineural invasion by epithelial ductal structures in two cases and of perineural and intraneural invasion in the third case led to initial diagnoses of well-differentiated adenocarcinoma. The presence of mucinous metaplasia in some of the cystically dilated ductal structures and the diffuse proliferation of pyloric-type glands probably contributed to the erroneous diagnosis of adenocarcinoma. Although the mechanism by which the epithelial structures invade perineural spaces is unknown, we offer two possible explanations: (1) extension and growth of epithelial ductal structures along tissue planes of least resistance, such as the perineural space, and (2) growth of hyperplastic nerve trunks in close proximity to or within epithelial structures. The pattern of perineural invasion in cases of adenomyomatous hyperplasia should not be confused with adenocarcinoma. Attention to the general architecture of the lesion and the bland cytologic features of the glands and ductal structures should prevent this misinterpretation. The gallbladder should be added to the list of organs in which perineural invasion by benign epithelial structures has been described.

Adenocarcinoma↗
PubMed1995

Educational characteristics of tumor conferences in teaching and non-teaching hospitals.

Hospital tumor conferences (tumor boards) were observed and evaluated over an 18-month period to determine their organizational and educational characteristics as well as their impact on conference participants. In conjunction with a previous nationwide survey of tumor conferences, this study was designed to identify features that would facilitate the learning that occurs in conference sessions. Study investigators observed a regional sample of 43 tumor boards in 37 participating hospitals, which included 513 sessions at general (hospital-wide) conferences and 198 sessions at specialty conferences. A total of 1,866 tumor cases were presented during these 711 conferences. Participants completed questionnaires to supplement the investigators' evaluations. Session observations revealed several ways in which tumor boards could increase their educational impact on participants, including combining case presentations with presentations of related didactic material and using the method of progressive disclosure to promote increased participation in discussions related to retrospective case presentations. Improvements can be made in session organization and case presentation with the potential for increasing participant learning with little increase in the effort or expense associated with tumor conferences.

California↗
PubMed1994

The National Cancer Data Base report on trends in cancer patient staging.

BACKGROUND: Previous Commission on Cancer studies have examined trends in the staging of cancer patients. Reported herein are the most current National Cancer Data Base (NCDB) data on staging. METHODS: Two "calls for data" have yielded a total of 770,100 reports of patients with cancer eligible for staging. RESULTS: For all stageable sites combined, the percentage of cases with documentation of staging increased from 1985 through 1990 (53% in 1985 vs. 77% in 1990). Cancers of the colon and breast were staged most frequently. Of the 837 NCDB-participating hospitals, 557 (67%) staged 80% or more of the patients with cancer. CONCLUSIONS: These results suggest that the frequency of staging is a function of hospitals rather than physicians or types of patients. Many interrelated factors contributed to the increase in the frequency of staging.

Hospitals↗
PubMed1994

Involution and the etiology of breast cancer.

Because of the recognized relationship between aging and the development of cancer, the authors have proposed that the rate and extent of involution may be important factors in the etiology of breast cancer. They further have examined existing epidemiologic and histopathologic data to evaluate the possible association between abnormal involution and breast cancer risk. Evidence for the association is largely circumstantial, because studies have not been designed specifically to evaluate the relationship between the process of involution and breast cancer. Until studies are performed to compare histopathologically the extent of involution in breast cancer patients and age-matched controls, the role of involution in the etiology of breast cancer will remain uncertain.

Adult↗
PubMed1994

Patient characteristics, methods of diagnosis, and treatment of mucous membrane melanoma in the United States of America.

BACKGROUND: There is limited information regarding mucous membrane malignant melanoma. STUDY DESIGN: The American College of Surgeons performed a patient care and evaluation study of malignant melanoma for 1981 and 1987 to determine the presenting symptoms, methods of evaluation, clinical management, and disease outcome. Previous reports on malignant melanoma of the skin and ocular melanoma have been prepared. This report details the findings for 60 patients with mucous membrane melanoma diagnosed in 1981 and 97 patients diagnosed in 1987. RESULTS: The patients with mucous membrane melanoma were generally older than patients with either skin or ocular melanoma. Significantly more females than males were reported, with no significant change between study years. Proportionally, more blacks were diagnosed with this condition than in the previous studies of skin and ocular melanoma. The patients with melanoma in this study had a poor prognosis based on characteristics known to be important for skin melanoma. As for patients with skin melanoma, most patients with mucous membrane melanoma were treated with operation alone, but good results were infrequent in patients with mucous membrane melanoma. Local, regional, and systemic recurrences were significant problems and overall survival was poor. CONCLUSIONS: We need new methods of treating these patients to control the disease and improve survival rates.

Adult↗