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Biomedical subjects

N Martini

Publications and source records attributed to N Martini.

At least 145 records · Page 8Linked to original sources
PubMed1982

Treatment of esophageal carcinoma combined preoperative chemotherapy.

Thirty-four patients with epidermoid carcinoma of the esophagus received a triple-drug regimen preoperatively consisting of cisplatin, vindesine, and bleomycin. Partial response to chemotherapy (greater than 50% reduction in measurable tumor size with concomitant improvement in swallowing function) was noted in 65% of the patients. Of the 34 patients, 28 (82%) had resectable disease. A one-stage high esophagogastrectomy utilizing the end-to-end anastomosis stapling device was performed on all 28 patients. Operation was followed by external radiation therapy to the esophageal bed, to a tumor dose of 5,500 rads delivered in 5 weeks. The postoperative median follow-up is now 14 months (range, 7 to 36 months). Thirteen patients are alive and well, and 10 patients have relapsed, 4 of whom are still alive with disease. Two patients died of postoperative complications, and 1 death was drug related. On the other hand, 5 of the 6 patients with unresected tumors died within 5 months. While the preliminary results are encouraging, longer follow-up will be required to determine whether the response rate to chemotherapy will result in a longer disease-free interval and longer survival.

Adult↗
PubMed1982

Complications of surgery in the treatment of carcinoma of the lung.

Nine hundred sixty-one patients underwent operations for the treatment of carcinoma of the lung; 18 percent of these were 70 years of age or older. The effect of various factors, singly or in combination, on the incidence of postoperative complications was assessed. Variables included age, sex, cardiopulmonary status, cell type, stage of the disease, and type of procedure performed. The postoperative course was uneventful in 81 percent of the patients; 8 percent had minor complications, 9 percent major complications and 2 percent died. The majority of the complications were cardiorespiratory. High risk factors were identified to be old age, restricted cardiopulmonary reserve, and the need for pneumonectomy. The low incidence of mortality and major morbidity observed was attributed to careful preoperative evaluation, selection of the appropriate surgical procedure, and inclusion of routine preoperative physiotherapy in all patients.

Adult↗
PubMed1982

VAB-3 combination chemotherapy in primary mediastinal germ cell tumors.

Ten patients with primary mediastinal nonseminomatous germ cell tumors were treated with the VAB-3 protocol. All patients with measurable disease showed tumor regression with chemotherapy, but only two had sustained partial response allowing thoracotomy and resection of residual tumor after the second induction. Both patients received additional induction therapy and one also received irradiation; they have been free of disease 41+ and 40+ months from the beginning of chemotherapy. All other patients died from the disease.

Antineoplastic Agents↗
PubMed1982

Surgical treatment of pleural mesothelioma.

From 1939 through 1981, 170 patients were seen and treated for pleural mesothelioma. Twenty-one tumors were benign, 47 were fibrosarcomatous, and 102 were epithelioma. Resection was the main mode of treatment in benign and fibrosarcomatous mesothelioma. Treatment of diffuse epithelial mesothelioma presented the greatest challenge. Surgical therapy, radiation therapy, and chemotherapy were used in combination in these patients. The review of our patients treated prior to 1972 had shown no benefit from including pulmonary resection in the surgical treatment of these tumors. Since then, all patients with diffuse mesothelioma were treated by pleurectomy without pulmonary resection. Both internal and external radiation therapy were also used to enhance local control. Forty-nine percent of patients with epithelial mesothelioma lived 1 year. The median survival in patients whose disease was controlled by these methods was 21 months. Despite the poor prognosis in malignant mesothelioma, better controlled by these methods was 21 months. Despite the poor prognosis in malignant mesothelioma, better survival was achieved when the treatment included operation combined with radiation and chemotherapy.

Adolescent↗
PubMed1981

Combined modality therapy of esophageal carcinoma.

One hundred ten patients with epidermoid carcinoma of the esophagus were treated at the Memorial Sloan-Kettering Cancer Center (MSKCC) with combined modality techniques involving preoperative irradiation (RT) and surgery, and with preoperative chemotherapy (CT), surgery, and irradiation. For the 76 patients receiving preoperative RT during the period 1965-1976, the overall resectability rate was 54% with an operative mortality of 12%; long-term survivors (greater than 3 years) were few (7%). For 34 patients receiving preoperative CT with cisplatin and bleomycin, major objective tumor regression (greater than 50%) was seen by day 18 in 20%, with an additional 44% having smaller but definite improvement in the barium esophagram and in swallowing function. Of those receiving preoperative CT, 76% had resectable lesions, with an operative mortality of 11%. The median follow-up for this group is 24 months; of the 30 patients followed for at least 12 months, 20% are alive without evidence of disease. Although the resection rate following preoperative chemotherapy seems to be higher, thus allowing better palliation, neither preoperative radiation nor chemotherapy with cisplatin and bleomycin have had a major impact on long-term survival.

Adult↗
PubMed1981

Detection of true pathologic stage I lung cancer in a screening program and the effect on survival.

One-hundred-sixty-nine lung cancers have occurred to date among 10,040 cigarette smoking men who participated in the New York Lung Cancer Detection Program. Almost 40% of the cases, 65, were still Stage I when their disease was diagnosed; 62 had thoracotomy and resection, and in 57, mediastinal node dissection confirmed that the mediastinum was free of metastases ("true pathologic" Stage I). Fifty-four of the 62 (87%) are still alive at this time, while only 15 of 104 (14%) of those with Stage II and III lung cancers are alive. Only two patients of the 62 in Stage I who were treated by resection died of lung cancer, both with T2 tumors. Two others are alive with metastases, one died postoperatively, and five died of other causes without evidence of lung cancer. The estimated probability of survival for true Stage I lung cancer is over 90% at five years, and close to 40% of all lung cancers can be detected in this favorable stage by present radiologic and cytologic screening techniques.

Adenocarcinoma↗
PubMed1981

New trends in skeletal reconstruction after resection of chest wall tumors.

Involvement of the chest wall in malignant tumors, either primary or resulting from contiguous or metastatic spread, occurs in less than 5% of thoracic malignancies. From 1963 through 1978, 155 patients had chest wall resection in continuity with the tumor. Eighty-five tumors were carcinomas, and 70 were sarcomas. Since 1973 reconstruction of chest wall defects in 12 patients has included the use of a composite of Marlex mesh and methyl methacrylate. It provides an excellent replacement both physiologically and esthetically. Such a reconstructed chest wall has obviated the need for postoperative respiratory support. The overall mortality was 4.5% (7 out of 155). The 5-year survival in this varied group of patients is 20%. We believe excellent palliation can be achieved even in patients who are not potentially curable.

Adolescent↗
PubMed1981

Cisplatin and vindesine combination chemotherapy for advanced carcinoma of the lung: A randomized trial investigating two dosage schedules.

Eighty-five patients with advanced squamous carcinoma or adenocarcinoma of the lung were randomly assigned to receive vindesine with either high dose (120 mg/m2 of body surface area) or low dose (60 mg/m2) cisplatin. All patients had measurable disease and had not previously received chemotherapy. The response rate was similar with both treatments (43% complete and partial remission rate), but the high dose cisplatin regimen was superior to the low dose in median duration of response (12 versus 5.5 months; p = 0.05) and in median survival for responding patients (21.7 versus 10 months; p = 0.02). Myelosuppression was generally not a treatment problem; peripheral neuropathy and moderate azotemia were the major dose-limiting toxicities. With improved survival and response rates over those reported for conventional regimens, this combination of new agents supports the approach of new drug investigation in patients with lung cancer and the importance of the incorporation of active new agents into initial chemotherapy regimens.

Adenocarcinoma↗
PubMed1981

Cellular schwannoma: a variety of schwannoma sometimes mistaken for a malignant tumor.

Fourteen cellular schwannomas, a variety of peripheral nerve sheath tumor showing a predominantly compact cellular growth, no formed cellular palisades or Verocay bodies, but the ultrastructure of schwannomas, are reported. A presumed nerve of origin was identified in three instances. The tumor had no sex predeliction; the mean age was 48. The neoplasm is usually well encapsulated and most commonly presents in the neck, posterior mediastinum, or pelvis. Because of a variety of confusing histologic features, including dense cell bundles and fascicles, storiform areas, a moderate mitotic activity and moderate nuclear atypia, six of 14 cases were mistaken for either fibrous histiocytoma, leiomyoma, malignant peripheral nerve sheath tumor, or sarcoma of uncertain type. In two instances the false impression of a malignant tumor was reinforced by clinical evidence of bony erosion and destruction. Follow-up thus far has shown the tumor to be benign.

Adult↗
PubMed1980

Occult carcinomas of the lung.

In 1974, we reported 26 patients with roentgenographically occult lung carcinomas. In 13 (50%) of them, the tumor was localized and treated by resection while the disease was still early (Stage I). These patients have done well, and the median survival has reached 8 years. We have added 21 patients to the series since our last report. Localization was by fiberoptic bronchoscopy in all 21. Fourteen of these patients had Stage I disease and were treated by resection. Of a total of 27 patients with early disease treated by resection, none has had recurrence after follow-up extending from 2 months to 20 years. However, in 21 of the entire 47 patients (45%) a second carcinoma developed, 15 (71%) of which were second lung carcinomas.

Adult↗
PubMed1980

Radiologic diagnosis of oat cell cancer in a high-risk screened population.

A screening program of 10,040 cigarette-smoking men over 45 years of age was undertaken in an attempt to achieve earlier diagnosis, thereby increasing the cure rate, of oat cell lung cancer. Of the 155 men who were found to have lung cancer, 27 (17%) had confirmed oat cell cancer. Only one case was diagnosed at the first examination. The other 26 cases (called incidence cancer) were diagnosed by subsequent examinations. In 24 of the 26 patients, the tumor was not found until it was advanced (Stage III), and of these patients, only one is alive at 21 months follow-up. Two tumors were diagnosed as oat cell carcinoma at an early stage (Stage I), and both patients are alive with no evidence of disease at seven and 24 months. The screening program used in this study did not succeed in detecting oat cell cancer at an early stage.

Aged↗