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Biomedical subjects

N Natarajan

Publications and source records attributed to N Natarajan.

At least 55 records · Page 3Linked to original sources
PubMed1986

Risk factors and current management in carcinoma of the endometrium.

Approximately 3,000 women die each year in the United States of carcinoma of the endometrium. Statistics which have been complied by the American Cancer Society record 39,000 new instances each year. This high cure rate is dependent upon the frequent and correct use of diagnostic techniques and the excellent patient education programs now in use. The results of this study also collaborate the value and cost effectiveness of the patient receiving treatment in community-based comprehensive therapy centers or properly equipped hospitals. In this survey, patients are identified who are at high risk for having carcinoma of the endometrium and prognostic factors which are frequently discovered by careful pretherapy evaluation are discussed. The current therapy methods being used today are presented so that trends are easily detected. The data entered by 546 participating hospitals are not to be used as a guide to therapy, but as a study of the current state of the art in the treatment of this malignant disease.

Adenocarcinoma↗
PubMed1985

National survey of patterns of care for Hodgkin's disease.

Patterns of care for Hodgkin's disease were surveyed through voluntary audits of hospitals with cancer programs approved by the Cancer Commission of the American College of Surgeons. Four hundred seventy-three hospitals reported 6314 patients in the long-term survey (patients diagnosed immediately preceding December 31, 1975), and 611 hospitals identified 3168 new patients in the short-term study (patients diagnosed immediately following January 1, 1981). The latter represent 45% of the estimated annual incidence in the United States. Comparison of the two studies showed changes in the procedures employed in staging, including an increased use of lung and abdominal computed tomography and bilateral bone marrow biopsies. Use of upper mantle plus periaortic node radiotherapy increased, whereas the inverted-Y field decreased. The use of single-agent chemotherapy decreased, and MOPP (nitrogen mustard, vincristine, procarbazine, and prednisone) chemotherapy increased. The survival rates varied with age, being better at younger ages and worse in the elderly.

Adolescent↗
PubMed1985

Race-related differences in breast cancer patients. Results of the 1982 national survey of breast cancer by the American College of Surgeons.

Data from the 1982 breast cancer survey of the American College of Surgeons were used to evaluate factors related to clinical, epidemiologic, and survival differences between black and white patients. Breast cancer in blacks was not discovered as early as in whites. Distribution of pathologic types of tumors were similar for both races with the exception of medullary carcinoma, which was more frequent in blacks than in whites. Estrogen receptor-positive tumors were found significantly less frequently in blacks compared with whites. Survival was better for whites compared with blacks within each axillary nodes group 0, 1 to 3, and 4+. Black women with negative or positive estrogen receptors had lower survival rates than white women of the same receptor status. A regression analysis using Cox's proportional hazards model showed race, clinical stage or axillary nodal status, age at diagnosis, and estrogen receptor status as significant predictors of survival. Significant differences between black and white patients were also observed with respect to the report of family history of breast cancer, age at first pregnancy, number of pregnancies, and age at cessation of menses.

Analysis of Variance↗
PubMed1984

Intracoronary streptokinase therapy in the coronary care unit for acute myocardial infarction.

Intracoronary streptokinase was offered and preliminary coronary angiography performed in 14 patients who were seen with the clinical diagnosis of acute myocardial infarction within 4 h of onset of symptoms. The procedure was performed in the Coronary Care Unit (CCU) of St. Peter's Medical Center with the use of a portable C-arm fluoroscope. Angiography was recorded on video tape. Service was provided by an "on-call" team consisting of two physicians, a CCU nurse, and a radiology technician, on a 24-h service basis. Adequate visualization of coronary anatomy was obtained in all patients. Patency of occluded vessels was achieved in 10 of 11 patients who received intracoronary streptokinase. The initial streptokinase bolus was administered at a mean interval of 4.1 h from onset of symptoms. It is concluded that speedy and effective coronary thrombolytic therapy can be provided in the CCU on a 24-h service basis by an on-call team. The use of CCU for this purpose will make this therapy widely available across the country, without the need for Cardiac Catheterization Laboratory.

Adult↗
PubMed1984

Patterns of care survey data on family history and ulcerative colitis in rectal cancer.

Data from a short-term survey on rectal cancer, sponsored by the Commission on Cancer of the American College of Surgeons, were analyzed in order to assess the association between family history of bowel cancer, ulcerative colitis, and rectal cancer. Overall, 7.4% of rectal cancer patients had a positive family history of bowel cancer and 2.5% reported personal history of ulcerative colitis. The association between these two factors was statistically significant. Patients with a positive family history were significantly younger than those without a family history of bowel cancer. Significantly more white patients than black patients had positive family histories. Significantly greater proportions of patients with earlier stage disease and well differentiated tumors were observed among persons with a family history of bowel cancer. No such association was observed among patients with a history of ulcerative colitis.

Adult↗
PubMed1984

The 1982 national survey of carcinoma of the breast in the United States by the American College of Surgeons.

The 1982 survey documented changes in the management of carcinoma of the breast in this country. If one compares the current survey results with the results of the 1978 survey, an inescapable conclusion is that there is a changing understanding of carcinoma of the breast and a willingness to apply new knowledge to clinical practice. These results also show the potential of the hospital Tumor Registry when records are systematically aggregated and data from different points compared. Future applications of this survey procedure and further analyses of these data may be used to document progress in the control of cancer. While useful for these purposes, it should be noted that these data are not intended, nor suited, for assessing the superiority of given treatments. They may not reflect the outcome that would result from a clinical trial. Comparisons made herein often involve patients who differed in many respects other than that on which the comparison was focused. However, within these constraints, the data may be useful for clinicians and scientists interested in the dynamic state of the treatment of carcinoma of the breast in large numbers of hospitals in the United States.

Adult↗
PubMed1984

Management of cutaneous melanoma in the United States.

Melanoma is an especially important malignant disease for surgeons to know about, since it can be cured with surgical treatment if diagnosed at an early stage. In the American College of Surgeons Melanoma Survey of 4,545 melanoma patients diagnosed during 1980, the typical melanoma was relatively thin (less than 1.5 millimeters), not ulcerated (except in 9 per cent) and did not invade into the reticular dermis or beyond (level IV or V). The melanomas were most commonly located on the trunk in men and on the lower extremities in women. Eighty-eight per cent of the patients had no clinical evidence of metastases to regional nodes or to distant sites at the time of initial diagnosis. Only a small proportion (1 per cent) of patients in the survey were black and in most of these patients, their melanoma were located on the feet or hands. The treatment of melanoma was surgical in 92.5 per cent of the patients, with the majority of patients undergoing a wide excision of the melanoma as the initial form of treatment. Only one-fifth of the patients underwent elective regional node dissection for suspected micrometastases, and most of these patients had a tumor thickness exceeding 1.5 millimeters or a lesion invading to the reticular dermis (level III, IV or V). While the Breslow Microstaging Method is now recognized as the most important parameter that predicts the clinical course of the patient, this parameter was reported in only 45 per cent of the patients in the survey. The natural history of melanoma is changing, since the disease is increasing in frequency and becoming more curable. Surgical treatment should be tailored to the biologic aggressiveness of each individual patient's melanoma. This can be estimated by integrating such prognostic factors as the melanoma thickness, the presence or absence of ulceration, the level of invasion, the anatomic site and the gender of the patient.

Adult↗
PubMed1983

Breast cancer in the medial half. Results of 1978 National Survey of the American College of Surgeons.

In their previous report on the 1978 survey of breast cancer by the American College of Surgeons, the authors observed that the five-year cure rate was lower, but only marginally, in patients having tumors located in the medial half of the breast than those in the lateral half. In order to identify factors which might explain this difference, as well as to evaluate the contribution of additional irradiation towards improving the cure rates, further analysis was made of the group of 9401 women in the long-term survey, with particular attention to the size of the tumor, the age of the patient, and the extent of the nodal metastasis. This analysis demonstrates that the prognosis is quite similar between groups of patients with tumors in medial or lateral half of the breast. Irradiation given in addition to mastectomy did not appear to improve the prognosis of the patients as compared to that of those treated by mastectomy alone.

Breast Neoplasms↗
PubMed1983

Epidemiologic observations from the American College of Surgeons' survey on prostate cancer.

Data on the incidence and mortality from prostate cancer are available in this country and others, but there are few sources of information relating to widely prevalent clinical practices. The long- and short-term prostate cancer surveys conducted by the Commission on Cancer of the American College of Surgeons offer a system of assessing patterns of cancer patient care in a large number of hospitals in the United States. Data from the Surveillance, Epidemiology, and End Results (SEER) System indicate that at every age blacks experience greater rates of incidence and mortality than whites. Comparisons of modes of diagnosis reported for black and white patients for 1974 and 1979 from the American College of Surgeons surveys show little difference between these groups, indicating that the excess in incidence among blacks is not attributable to differential patterns of diagnosis. The survey results also indicate that white patients appear to have a slight survival advantage in stages B, C, and D. The lower survival appears to be the product of relatively advanced stage of the disease rather than the result of biologically more malignant nature of prostate cancer in the blacks.

Adult↗
PubMed1983

Adenocarcinoma of the colon masquerading as primary ovarian neoplasia. An analysis of ten cases.

This paper reviews the clinical characteristics of a group of patients in whom unsuspected primary adenocarcinoma of the colon presented with signs and symptoms of a primary ovarian neoplasia. In most patients, the ovaries were removed, the correct diagnosis was established at a later time, and a second surgery for resection of the primary adenocarcinoma of the colon was then performed. Preoperative use of colonoscopy or barium-enema examination would have helped. We compared these patients to a group of patients with similar clinical characteristics, but in whom the ovarian metastases were clinically apparent months after the resection of a primary colorectal cancer. We found that, in both groups, age of the patients, anatomic distribution of the primary tumor, histologic differentiation, serosal or mesenteric lymph node tumor involvement, and timing of the oophorectomy in relationship to removal of the primary colorectal tumor did not affect the overall survival. Once ovarian metastases were documented, patients died regardless of treatment, approximately 16 1/2 months after the diagnosis.

Adenocarcinoma↗
PubMed1982

Patterns of breast cancer detection in the United States.

The American College of Surgeons Commission on Cancer Short-term Survey of Breast Cancer in 12,315 patients showed that 73% of malignant tumors are found by patients, 23% by physicians, and 4% by mammography. It also indicated that younger women are more likely to discover tumors than older women, and that mammography is more likely to detect small tumors with negative axillary nodes. The effectiveness of mammography is most evident in women 50 to 74 years of age, although in women 45 to 49 years, the frequency of tumors detected by mammography nearly equals that for other groups. In black women, mammography may not be currently fully utilized. Analysis of the survey data would indicate that patients appear to demonstrate adequate skill in detecting tumors, as compared to physicians. A delay in diagnosis of longer than 3 months is associated with larger tumors and increased likelihood of axillary metastasis.

Adenocarcinoma↗
PubMed1982

Management and survival of adenocarcinoma of the rectum in the United States: results of a national survey by the American College of Surgeons.

Data from the long- and short-term surveys of the American College of Surgeons Commission on Cancer were examined to evaluate the survival and management of patients with rectal cancer in the United States. Overall, females experienced better survival than males, and white had better survival than blacks. The 5-year survival rates for localized, regional and distant stages of the disease were 76.4, 43.1, and 5.5% respectively. The survival rates in relation to histologic grade of the tumor indicated that the survival experiences of patients with well and moderately differentiated tumors were similar (57% versus 54%) and that patients with poorly differentiated tumors had significantly lower survival (35%). The survival experience of those receiving abdominoperineal resection was similar to those treated by low anterior resection (56% versus 58%). Location of the tumor in the rectum did not affect prognosis.

Adenocarcinoma↗
PubMed1982

Metachronous ovarian metastases from adenocarcinoma of the colon and rectum.

Our observations indicate that the menopausal status of a patient, the anatomic location or the histologic differentiation of a primary adenocarcinoma of the colorectal area does not seem to affect the incidence of ovarian metastases. Tumors initially classified as Dukes' B2 and, later, associated with ovarian metastases have consistently poorer prognosis. The reason that ovarian metastases attain a relatively large size, while other metastatic foci remain small, is unknown. Regardless of the surgical findings, patients with ovarian metastases from a primary adenocarcinoma of the colorectal area tend to have short survival with widespread distribution of the tumors at death. This would suggest that these metastases occur primarily by the hematogenous route rather than by an orderly invasion to contiguous structures and draining lymph nodes. Patients with resectable solitary ovarian metastases and prospectives of cure must be a rare event in carcinoma of the colon and rectum.

Adenocarcinoma↗