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Biomedical subjects

J S Spratt

Publications and source records attributed to J S Spratt.

At least 91 records · Page 5Linked to original sources
PubMed1979

Relation between mammary cancer growth kinetics and the intervals between screenings.

The purpose of this study was to consider the time interval for periodic mammographic screening for breast cancer. One hundred fifteen breast cancers occurring in 10,128 women receiving over 30,000 mammograms over a four year period were reviewed. Tumors were diagnosed at three time intervals: 1) first screening (39/115); 2) annual examination (27/115); and 3) at an examination that occurred less than twelve months from a previous annual examination (10/115). Also, there were tumors that grew to a palpable dimensions and were self-detected between annual examinations (39/115). Our opinion is that screening intervals should be individualized to each patient according to risk factors and suspicious mammographic findings. Further, there is a significant number of breast cancers that grow too fast to be detected effectively by annual mammography. Suspicious mammographic findings did not exist before these cancers reached palpable dimensions. Other risk factors characterizing the hosts who develop these fast growing cancers are yet to be determined.

Biopsy↗
PubMed1979

The results of treatment of perineal recurrence of cancer of the rectum.

A study of 36 patients with adenocarcinoma of the rectum recurrent in the perineum after Miles abdominoperineal resection defined a subgroup of 21 patients in whom curative re-excision of the perineum, with or without associated resection of viscera as warranted by operative findings, was performed. Recurrence without palpable disease was disclosed microscopically in seven patients (33%). None of the 21 patients had clinical or laboratory evidence of dissemination at the time of re-excision. Mortality and morbidity were low and yield in terms of pain control was excellent. Results achieved in patients treated with pre- and/or postoperative radiotherapy did not differ quantitatively or qualitatively from those treated by operation alone. Survival free of disease proved to be disappointing and underlines at present the palliative nature of this approach when the primary operation has been an adequate standard abdominoperineal operation. This report provides further evidence as to the value of the better definition of high risk primary rectal cancers and the need for continuing refinement of the follow-up and retreatment process.

Adenocarcinoma↗
PubMed1979

Growth rates of primary breast cancers.

The growth rates of breast cancers are a critical aspect of the natural history of the disease. Growth rates of 32 primary breast cancers were determined from serial mammographic views of tumor nucleus shadows in a population of 109 cancers. These cancers were found in a screening population of 10,120 women receiving over 30,000 mammograms over 3 years. Tumor volume doubling times ranged from 109 days to 944 days with mean doubling time of 325 days in 23 cases with 9 tumors showing no growth. Additional cancers surfaced that were growing too fast to be measured. These cancers were significantly more likely to metastasize but because of the small sample size the absolute percentage of tumors in that fast growing subset was not determinable but ranged between 17 and 77% of the 109 cancers.

Breast Neoplasms↗
PubMed1979

Cancer of the breast. Surgical management.

We have reviewed a variety of surgical techniques for mastectomy, endocrine gland ablation and the management of pathologic fractures and pleural effusion. With their judicious use for the chronic disease of mammary cancer, many persons can be cured and many others can be given long periods of symptom-free survival. With (1) attention to proper indications and contraindications for surgery, (2) surgical detail and (3) good patient care, very few patients will be made worse.

Adrenalectomy↗
PubMed1978

Treatment policies affecting survival in patients with carcinoma of the cervix.

Radiotherapy treatment techniques were evaluated according to survival rates among more than 800 patients with Stage I and II carcinoma of the cervix. An increased survival rate was noted when a Fletcher tandem and ovoids and the Fletcher technique of external irradiation and fractionated radium therapy were applied. This increase was due to a larger radiation dose to the anoxic tumor core and to external irradiation shrinking the tumor to within the high-dose range of radium therapy.

Female↗
PubMed1977

Multiple primary cancers: review of clinical studies from two Missouri hospitals.

A composite review of a series of hospital-based, clinical studies on the prevalence of simultaneous and nonsimultaneous multiple primary cancers, including those in which data were recorded by the life table method for six different series of cancer patients and one "control" series of patients who did not have cancer at first contact is provided. The studies came from Barnes Hospital and the Ellis Fischel State Cancer Hospital (EFSCH) and span the period from 1914 through 1964. The conclusions of the studies support the concept that the presence of one primary cancer neither increases nor decreases the chances for developing additional cancers with the possible exception of a few "target organ" areas. One study of this period showed a nonrandom distribution of patients with multiple primary cancers referred to EFSCH and this observation merits further epidemiologic research.

Adolescent↗
PubMed1977

Factors affecting survival in over 500 patients with stage II carcinoma of the cervix.

Charts were reviewed of 519 patients with stage II (League of Nations) carcinoma of the cervix to determine those factors in the history, work-up, and treatment which affected survival. Those factors which correlated with a significant decrease in five-year survival were abnormal admission blood urea nitrogen level or excretory urogram, a history of pelvic pain or weight loss over 10 kg (20 lbs.), or tumor extension to the endocervix or uterus. These factors, as well as the results of lymphangiography, should be included in the staging of carcinoma of the cervix.

Adenocarcinoma↗
PubMed1977

Cytokinetic definition of acute and chronic breast cancer.

The purpose of this paper is to report the extant observations at the Ellis Fischel State Cancer Hospital-Cancer Research Center and in the literature on the gross rates of growth of human mammary cancer as measured for primary cancers in the breast by mammography and for metastatic cancer in the skin and lymph nodes by direct measurements. From these measurements, the gross or net rates of growth for the cancers have been calculated and reported as actual doubling times. Cytokinetic variables contribute to the observed growth, and the data are used to estimate the potential acuteness or chronicity of breast cancer.

Acute Disease↗
PubMed1976

Scalene node biopsy in the pretreatment staging of carcinoma of the cervix uteri.

This study reports the experience at the Ellis Fischel State Cancer Hospital with the use of scalene node biopsy for the pretreatment evaluation of patients with carcinoma of the cervix uter. The study was stimulated by a report from the National Cancer Institutes which stated that impalpable scalene nodes contained metastatic cancer in 13 per cent of a series of 84 cases. By a meticulous biopsy technique, we were unable to confirm this high incidence, In a series of 73 cases, no impalpable lymph nodes were found to contain metastatic cancer regardless of the clinical stage of the cancer. Consequently, we have terminated the use of scalene lymph node biopsies in the staging of cervical cancer for primary treatment. The study is still in progress to evaluate patients with recurrent cervical cancer who may possibly require pelvic exenteration. Also, the procedure will be continued in patients referred for further treatment in whom carcinoma was first diagnosed as an unsuspected finding in a hysterectomy specimen.

Adenocarcinoma↗
PubMed1976

Analysis of variance and covariance for colorectal adenocarcinomas in man as a logical prelude to "staging".

This study reports initial experience at the Ellis Fischel State Cancer Hospital (EFSCH), Columbia, Missouri, with the analysis of variance and covariance as applied to the ability to predict the lethality associated with colorectal neoplasms as influenced by tumor,host, and treatment variables considered individually and as multivariate clusters. The application of the methods to the clinical setting is based on the fact that each patient has one survival time. However, in the mathematical sense, each patient is composed of many different variables interacting simultaneously in highly complex ways to determine this uniqueness. The feasibility of determining the prognostic score or weight of many variables is illustrated. The combinatory effect of these scores can provide prognostic scores for clusters of variables providing a tool of much greater specificity than is provided by traditional staging systems such as the TNM.

Adenocarcinoma↗