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Biomedical subjects

M T Pheils

Publications and source records attributed to M T Pheils.

At least 19 recordsLinked to original sources
PubMed1986

An evaluation of the American Joint Committee (pTNM) staging method for cancer of the colon and rectum.

This study, using prospective data, compares the survival of 1011 patients who had a colorectal cancer resected at Concord Hospital between 1971 and 1983. The results are expressed both in terms of Australian clinicopathologic (CP) staging and the modified pTNM method proposed by the American Joint Committee for Cancer Staging and End Results reporting. The aim of the study was to determine which of the two staging methods gave the better guide to prognosis. The results indicate that pTNM does not add to information beyond that given by CP staging. We conclude that the pTNM classification is only partially able to separate patients into different survival groups; it is complicated and difficult to memorize, and does not give useful prognostic information beyond that provided by the simpler CP system.

Australia↗
PubMed1986

Surgery for large bowel cancer in people aged 75 years and older.

Three hundred ten predominantly male patients who were 75 years of age or older and had surgery for colorectal carcinoma had a hospital mortality rate of 9 percent and a cancer-related five-year survival of 50 percent. These results and a detailed analysis of the causes of complications and mortality were compared with the outcome of 710 patients who were treated concurrently and who were younger than 75 years. Tumors in older patients had a tendency to occur on the right side and were more locally advanced. Increased mortality was particularly attributable to sepsis and cardiovascular causes. Increased morbidity was due principally to respiratory and urinary problems. There were no significant differences, however, in wound or anastomotic complications, nor was therapy for the older patients more costly. The indications for surgical resection for colorectal cancer in patients aged 75 years and older should be the same as those for any younger group.

Adenocarcinoma↗
PubMed1985

A multivariate analysis of clinical and pathological variables in prognosis after resection of large bowel cancer.

Data on 709 patients who had a resection for colorectal carcinoma at Concord Hospital between 1971 and 1980 were studied to determine the independent effects on survival of several patient characteristics and pathological variables using the Cox regression model. Clinicopathological stage had the strongest association. Other variables ranked according to their relative importance independent of stage were: histological grade, level of direct spread, the presence of venous invasion, age and sex of the patient and the presence of obstruction.

Adenocarcinoma↗
PubMed1985

The relationship between different staging methods and survival in colorectal carcinoma.

A routine clinicopathologic (CP) staging system for patients who have had surgical resection for colorectal carcinoma was established at Concord Hospital in 1971. Research on this prospective series of resections has evaluated the CP staging system as a guide to prognosis. The aim of this study was to compare the CP system with the classic Dukes' staging system and its modified form introduced by Astler and Coller to determine which method provided the most accurate basis for prognosis. Life table survival analysis was used to examine the survival of 709 patients according to each staging system. Relative mortality rates for groups of patients cross-classified by each possible pair of staging systems were examined and the Cox regression model was used to determine the independent effects of staging by each system on survival. The CP system was found to have a stronger association with survival than either the classic Dukes' system or the Astler-Coller modification of the Dukes' system. The importance of supplementing data on the operative specimen with data about the spread of tumor beyond the limits of surgical resection is emphasized.

Aged↗
PubMed1979

A pattern of local recurrence following resection of colorectal cancer.

Twenty patients (10%) developed a local recurrence following 200 consecutive curative resections for colorectal carcinoma. Analysis of the pathology of the primary tumours suggests that invasion of adjacent tissues, and lymph node involvement, were more important presection on the mucosa. The average time interval between resection and diagnosis of local recurrence was 17 months. The average survival time following diagnosis was 10 months. Nineteen out of 20 of these patients developed evidence of disseminated disease subsequent to the diagnosis of local recurrence. The most effective palliation occurred in patients in whom the local recurrence could be resected.

Colonic Neoplasms↗
PubMed1977

Hepatic metastases from colorectal carcinoma: an analysis of survival rates and histopathology.

Out of 338 patients undergoing laparotomy and resection of a primary colorectal carcinoma, 49 (14-5%) were folnd to have liver metastases. The average age was 70 years. The median period of survival was 11-4 months. The histological grade of malignancy of the primary tumour did not appear to influence the survival rate. Compared with similar tumours in patients without hepatic metastases, the primary growth showed a significantly increased incidence of venous invasion, a higher grade of malignancy, and a more frequent origin from the right colon. When the local spread of the primary tumours was investigated it was found that one-third of them had not progressed beyond Stage Dukes A or B.

Adenocarcinoma↗
PubMed1976

Colorectal carcinoma: a prospect clinicopathological study.

The clinical and pathological findings in 200 consecutive cases of colorectal carcinoma treated by surgical resection have been recorded and subjected to computer analysis. This is the initial report from a long-term prospective survey of this disease. The two most frequent presenting symptoms were altered bowel habit (51.5%) and bleeding (49.5%). Symptoms due to anaemia occurred in 16% of cases and acute obstruction in 13.5% of cases. The value of the various investigations in establishing the diagnosis is discusses. At the time of resection the disease had already reached an advanced stage in a majority of the patients. In 26% of cases it was known that complete resection of tumour tissue had not been achieved. A direct relationship between stage of spread and histological grade of malignancy was noted. The incidence of advanced stage, high histological grade and mucinous tumours was greatest in the right side of the colon. A study of early carcinomas has confirmed that many have arisen from benign epithelial neoplastic polyps. The significance of these observations is discussed.

Adenocarcinoma, Mucinous↗
PubMed1976

Closure of colostomy.

A retrospective review of 110 patients who had their colostomies closed during the period from 1963 to 1973 has been undertaken. Their average age was 64 years. Diverticular disease and colorectal cancer had been the most frequent indications for the colostomy. Wound infection occurred in 36.4% and faecal fistula in 7.3%. These complications occurred less frequently in patients who had antibiotic bowel preparation. The overall mortality rate was 4.5%. Measures to reduce the morbidity and mortality are discussed.

Adult↗
PubMed1975

Cholecystostomy for acute cholecystitis.

During the period from 1963 to 1970, 318 patients were subjected to early operation for acute cholecystitis. Cholecystostomy was performed in 25 cases (7.8 percent). Despite advanced age and associated serious illnesses, cholecystostomy was an effective and definitive method of treatment. Many of these patients are likely to succumb from intercurrent disease before they develop further stones or cholecystitis. A planned cholecystostomy may be the operation of choice for poor-risk patients with acute cholecystitis.

Acute Disease↗