Endocrine surgery in breast cancer.
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Biomedical subjects
Publications and source records attributed to F Badellino.
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Five-year results in 60 oral and pharyngeal cancer patients treated with combined approach chemoradiotherapy (39 patients) and chemoradiotherapy plus lymph node surgery (21 patients) are reported. Complete remission (CR) was achieved in 16/39 (41%) patients treated with chemoradiotherapy alone, and in 16/21 (76%) patients who had chemoradiotherapy plus surgery. The number of CR was statistically (chi-square test) higher (p less than 0.025) in the second group. The 5-year actuarial survival was 39.7% in the group of patients treated with chemoradiotherapy plus surgery. After 5 years 53% of the patients who reached CR are living free of disease in the first group and 76% in the second group.
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Resection of locoregional recurrences was performed after mastectomy in 50 cases in the period 1961-1974. An incidence of 2% to 35% is reported for such recurrences, which are due to a variety of factors. In the present series, attention was directed to age at mastectomy and at recurrence, size of primary tumour, presence of axillary metastases, and details of menarche, menopause and pregnancy. Mean age at mastectomy was 50 yr and at recurrence 53 yr. Tumour diameter ranged from 2 to 5 cm in 73% of cases. Lympho node metastases were present in 42%. In 80%, the recurrence was paracicatricial, in 13% parasternal, and in 7% axillary. Treatment consisted of resection, radiochemotherapy or endocrino-ablative management.
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Nine cases of untreatable tumour in which radical surgery was employed palliatively are presented. Three hemipelvectomies for recurrent rhabdomyosarcoma were performed. In one case, death occurred postoperatively, probably as a result of pulmonary embolism. One patient survived for 8 months, while the other is still alive after three years. Of two cases in which interscapulothoracic disarticulation was performed, survivals of 9 and 5 months were observed in subjects with fibrosarcoma in a mastectomy site and recurrent sarcoma of the humerus with ling metastases. Survival to 7 months was obtained in a case of sarcoma of the maxilla, while three patients with squama cell cancer of the mouth floor, chondrosarcoma of the mandible and botryoid sarcoma of the tonsillar fossa are still living after periods of 10 months to 2 yr. Though devoid of schematic indications, palliative demolition surgery can be considered in borderline cases where the operative risk is not high. Irrespective of "quantity", the "quality" of life remaining to the patients can be made compatible with the psychophysiological limits of the human personality.
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