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Biomedical subjects

E W Strong

Publications and source records attributed to E W Strong.

At least 109 records · Page 6Linked to original sources
PubMed1977

Chemotherapy of head and neck cancer: combination treatment with cyclophosphamide, adriamycin, methotrexate, and bleomycin.

A combination of cyclophosphamide, adriamycin, methotrexate, and bleomycin (CAMB) was explored in patients with advanced, nonresectable epidermoid carcinoma from primary sites in the head and neck, recurrent or persistent after radiation or surgery. Objective regression (greater than 50%) of measurable tumor was present in 35% of the patients. The median duration of response was 2.5 months. Median survival of responders was slightly less than the nonresponders, but the difference was not significant. Drug-related morbidity was substantial; leukopenia, mucositis, and weight loss were the most frequent major side effects. Three deaths were attributable to the regimen. The results seem comparable to those one might expect from methotrexate alone.

Adult↗
PubMed1977

Immunologic evaluation and prognosis in patients with head and neck cancer.

Patients with mucosal squamous cell carcinoma of the head and neck generally have suppressed T cell function, and this suppression tends to be more pronounced with progression of disease. The prognostic relationships of multiple tests of immune function were analyzed in 183 clinically staged patients. Correlation of immune parameters with prognosis was evident only with the DNCB response, which correlated with recurrence in stages I and II disease (but not in stages III and IV). There was no correlation of any of the in vitro tests of immunofunction with recurrence in any stage. There were no correlations between any of the immune parameters and age or sex nor between DNCB reactivity and any of the in vitro responses.

Carcinoma, Squamous Cell↗
PubMed1977

Mucosal melanomas of the head and neck.

Only 3 per cent of all melanomas arise in the mucosa of the head and neck region. Melanomas of mucosal origin in this series differed from their cutaneous counterpart in that size of the primary lesion did not influence prognosis. Regional lymph node metastases were infrequent and did not seem to influence prognosis. Nearly all the primary lesions on microscopic review showed the presence of intralesional lymphatic and blood vessel invasion. Local recurrence at the primary site was the most common cause of treatment failure, in spite of seemingly adequate surgical resection. Surgical treatment offers long-term cure to only a limited number of patients.

Adult↗
PubMed1976

Separate primary carcinomas of the esophagus and head and neck region in the same patient.

From 1949 to 1972 at Memorial Sloan-Kettering Cancer Center, 60 patients with primary cancers of both the oral cavity, pharynx, larynx (OPL) and esophagus were studied. In 15, the cancers occurred synchronously, and in 68% they occurred within 2 years of each other, the longest interval being 27 years. The tongue and extrinsic larynx were the most common sites of origin together with the middle third of the esophagus. During the same period, over 7000 patients with OPL and over 1000 patients with esophageal cancers were seen at this institution. The majority of patients had a history of excessive smoking and alcohol intake. Four out of nine who had previous radiation therapy for their OPL cancer developed esophageal cancer within the therapeutic field (three after 16, 25, and 27 years). Thirty percent (18/60) had three primary cancers; one had four, of which two were in the head and neck region. Two patients survived more than 5 years; both also had a third primary cancer of the lung. There are broader implications in this study: multiple primary cancers in general, and this group in particular, give us especially valuable clues as to the oncogenic influence of environmental factors as well as cellular, organ, and also systemic susceptibility. With one cancer, one can anticipate formation in other related organs. This provides an opportunity for early diagnosis, more effective management, and improved survival. The cause and effect relationship of tobacco and alcohol must be emphasized at every opportunity and most particularly to those who have developed one cancer in the oropharyngeal-laryngeal region.

Adult↗
PubMed1976

Carcinoma of the hypopharynx.

The data in this study suggest that radical surgical treatment offers the best chance for control of disease in patients with cancer of the hypopharynx. The cervical lymph nodes are at a very high risk for early involvement by metastatic disease. Elective treatment of cervical lymph nodes must be considered in initial treatment planning to obtain better control of regional disease.

Adult↗
PubMed1976

Tumors of the submaxillary gland.

This study reviews a thirty year experience with 217 patients who had a tumor of the submaxillary gland, comprising about 9 per cent of all patients with salivary neoplasms seen during the same period. Most of the tumors were malignant (56 per cent), with adenoid cystic carcinoma predominating, but the histologic type most frequently encountered was benign mixed tumor (43 per cent). Median age was fifty-four years in patients with malignant tumors compared with forty-six years in those with benign tumors, and 58 per cent were women. Asymptomatic swelling was the usual presenting complaint, and the clinical findings are summarized using a staging system recently proposed for patients with parotid tumors. Cervical lymph node metastasis occurred in at least 50 per cent of patients who had an adenocarcinoma or epidermoid, mucoepidermoid, or anaplastic carcinoma. Treatment was surgical and complete gland excision proved adequate in those with benign tumors. Radical neck dissection was performed in conjunction with submaxillary resection in most patients with malignant lesions, but radical en bloc resection was reserved for those few who had extensive or fixed disease. Net determinate "cure" rates at five and ten years (30 and 20 per cent, respectively) are distressingly low and compare unfavorably with those previously reported in patients treated for carcinoma of the parotid. The high local recurrence rate and the greater incidence in the submaxillary gland of more aggressive tumor types which metastasize readily suggest that current treatment should be more radical. It seems reasonable to expect that results might be improved if en bloc resections were more often performed in patients with less advanced disease, possibly in conjuction with intensive postoperative irradiation in selected cases.

Adenocarcinoma↗
PubMed1976

Carcinoma of the oral cavity. factors affecting treatment failure at the primary site and neck.

A retrospective review of the clinical records of patients with carcinoma of the oral cavity was undertaken, and several parameters were studied in terms of comparing two groups of patients: those who were controlled at the primary site and neck and others who failed locally or regionally following initial treatment. A comparative statistical analysis of the factors studied revealed that female patients who had a higher T status, a higher N status, and thus a higher stage of disease did poorly in terms of local and regional control of disease. Those patients whose primary tumors manifested deep invasion and those who had positive margins after surgical resection at the primary site had also a significantly high incidence of local/regional failure. Presence of extracapsular extension of disease in cervical lymph nodes and involvement of soft tissues in the neck as well as involvement of multiple lymph nodes at multiple levels also put the patients in a high risk category. We urge that these factors be considered as prognostic criteria and be used to select patients for treatment by additional modalities on an elective basis in hope of achieving better local and regional control of disease and perhaps better cure rates.

Carcinoma, Squamous Cell↗
PubMed1976

Clinical staging of cancer of the head and neck: a new "new" system.

A revised clinical staging system for cancers arising in head and neck sites has been prepared. It utilizes a uniform N classification for cervical node metastases. The T classifications describing the extent of the primary tumor are generally similar but differ in specific details for each site. Although the present system makes use of past field trials and more recent clinical studies, it cannot be considered final. Clinicians managing cancer in head and neck sites are encouraged to test the system with their own patient data to elicit further areas for improvement.

Head and Neck Neoplasms↗
PubMed1975

T-cell deficiency in patients with squamous cell cancer of the head and neck.

Cellular immunity was assessed in patients with operable squamous cell cancer of the head and neck using in vivo skin tests and in vitro lymphocyte stimulation tests. An expansion of a previous study continued to show that 30 per cent of patients with T1N0M0 lesions were DNCB-negative and that with more advanced lesions there was further impairment. A similar finding was observed in the blastogenic response to phytohemagglutinin and concanavalin A but not pokeweed mitogen. Overall, 40 per cent of patients with resectable cancer had a significant depression of the blastogenic responses to conconavalin A and phytohemagglutinin. This depression ranged from 15 per cent in patients with T1N0M0 lesions to 71 per cent in those with T3N0M0 lesions. Although this depression was more severe in patients with palpable cervical node metastases, it was related more to the size of the primary tumor than to the nodes per se. An exception occurred in patients with large fixed nodes in whom the depression of lymphocyte stimulation was most severe. The absolute T-cell count was also depressed in patients with head and neck cancer. This depression parallelled the lymphocyte stimulation results with phytohemagglutinin and conconavalin A and was progressive with increasing stage of disease. A correlation exists between DNCB negativity and early recurrence and shortened survival. Clinical follow-up study is too short to assess the correlation of in vitro immune function with these clinical prognostic factors.

Alcoholism↗
PubMed1975

Carcinoma of the glottic larynx.

During the years 1955 through 1964, 535 patients with histologically proved squamous cell cancer of the glottic larynx were recorded in the Tumor Registry of the Memorial Sloan-Kettering Cancer Center. Of these 521 were treated and form the basis of this report. All were retrospectively staged. Possible etiologic factors were tabulated associated diseases recorded, and results of treatment evaluated. In this almost wholly surgically treated series, the determinate five and ten year survival rates for previously untreated patients were 81.5 and 80 per cent, respectively. The incidence of cervical lymph node metastases increased and the prognosis worsened with increasing stage of disease. The previously treated patients had a much worse prognosis than did the primary patientsmcancer of the glottic larynx is eminently curable if detected early and treated adequately.

Adult↗