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O Dworak

Publications and source records attributed to O Dworak.

At least 37 records · Page 2Linked to original sources
PubMed1996

Is local excision of pT1-ampullary carcinomas justified?

We propose that local excision of carcinomas of the ampulla of Vater is justifiable under the following conditions: when the tumour is limited to the ampulla of Vater as diagnosed by pre-operative endoluminal sonography (uT1) and UICC-staging (pT1); and when it is graded G1 or G2 and there is no lymphatic infiltration and the tumour is completely resected (R0). Under these conditions peri-operative morbidity and mortality were significantly reduced compared with more extensive surgery. There was no local recurrence of tumour in our study and long-term survival rates were comparable with Whipple's procedure. This implies that lymphatic spread is limited in localized disease and the feasibility of the proposed procedure may therefore be analogous to localized resections in other malignant tumours, e.g. carcinoma of the rectum.

Adult↗
PubMed1996

[Distribution of lymph nodes and lymph node metastases in esophageal carcinoma].

BACKGROUND: Lymph node metastases are an independent prognostic factor in esophageal cancer. Accurate pathologic work up depends on detailed knowledges of number and anatomic distribution of lymph nodes and metastases. Factors that may determinate metastatic spread are also important. METHODS: One hundred and fifty-six patients with esophageal cancer were included in this study. Number and localization of nodes and metastases were documented and correlated with localization, infiltration deepness and grade of malignancy of the tumor. The effectivity of the search for nodes and metastases was also studied. RESULTS: We found 3869 lymph nodes containing 338 metastases in the 156 specimens (median 25 and 2). 53.2% of the cases exhibited metastases and 15.4% contained only solitary metastasis. The minimal number of lymph nodes for excluding of metastasis was about six nodes. Most of the nodes were found at lower esophagus and on the oral stomach resection. Tumors of the middle and upper thoracal esophagus spread also frequently to the nodes along the lesser curvature of the stomach. Between infiltration deepness and grade of malignancy of the tumors a positive association was found. CONCLUSIONS: Lymph node metastases are a frequent pathological feature in esophageal cancer which depends on infiltration deepness and grade of malignancy of the tumor. This allows the estimation of metastatic spread. For staging a minimum of six nodes must be found in the specimen. In this context the frequent metastases along the lesser curvature of the stomach must be considered.

Adenocarcinoma↗
PubMed1995

[Hamartoma of aberrant breast tissue in the inguinal region].

Ectopic mammary tissue reportedly has an incidence of 1 to 6%, and is usually found in the axilla. Neoplasias in ectopic breast tissue are rarely observed. This is the first report of an hamartoma of ectopic breast tissue in the inguinal region. A 50-year old woman presented with a large tumor in the groin. The unusual site and form of the tumour preoperatively suggested a chronic incarcerated hernia. When laparoscopy excluded a hernia, the tumour was resected in accordance with oncological criteria and the histopathological work up revealed the surprising findings. This case shows that ectopic mammary tissue, in particular when it is the site of a tumor, may be a rare differential diagnosis of an inguinal tumor.

Breast↗
PubMed1995

[Preoperative radiochemotherapy in primary non-resectable rectal cancer].

PURPOSE: In a pilot-study patients with primarily non-resectable rectal cancer received a pre-operative radiochemotherapy to assess the tolerance and efficacy of this treatment protocol. PATIENTS AND METHOD: Twenty patients with non-resectable rectal cancer (Mason CS III-IV) have been irradiated from September 1989 through February 1994. The total dose, calculated at the isocenter, was 50.4 Gy with 5 fractions of 1.8 Gy per week with a small volume boost in selected cases. Chemotherapy was administered on 5 consecutive days in week 1 and 5 with 1000 mg/m2 5-FU per day as continuous infusion over 120 hours. RESULTS: The treatment was well tolerated. Acute toxicity included 1 grade III-dermatitis, 7 grade II-enteritis, 1 grade III- and 3 grade II-leucopenia. Seventeen out of 20 patients were resected 6 weeks after radiochemotherapy, 3 patients had no surgery (1 toxic death due to septicemia, 1 refusal of surgery after complete remission, 1 thrombocytopenia due to liver cirrhosis), all 3 had at least partial remission of their tumors. Fourteen out of 17 (82%) resections were curative (R0) with 1 additional R1- and 2 R2-resections. Ten out of 14 (71%) curative resected patients had no lymph node metastasis. A detailed histological examination showed regression in 15/16 tumors with fibrosis and vascular wall changes. Nine out of 16 patients had only minimal residual tumor. CONCLUSIONS: In this pilot study, pre-operative radiochemotherapy was well tolerated. The relatively high rate of curative resections and marked histological tumor regressions of this approach requires further investigations in a randomized trial.

Adenocarcinoma↗
PubMed1994

Hamartoma of an ectopic breast arising in the inguinal region.

Ectopic mammary tissue in the inguinal region giving rise to a hamartoma is reported. This localization of ectopic breast is infrequent and hamartomas of the breast at this site have not been described previously. The unusual size of the lesion caused pre-operative diagnostic difficulties.

Breast↗
PubMed1993

Carcinosarcoma in Barrett's oesophagus: a case report with immunohistological examination.

A case of a carcinosarcoma which developed in a Barrett's oesophagus is presented. The tumour consisted of an adenocarcinoma and a spindle cell sarcoma. Immunohistological examinations demonstrated vimentin positivity in the sarcomatous portion with a negative reaction for keratin. Immunohistological and histological findings did not rule out the possibility of a double or collision tumour in this case.

Aged↗
PubMed1992

A 30-s PAS stain for frozen sections.

A modified periodate-Schiff's procedure technique for application in frozen section diagnosis is described. This simplified reaction performed using a microwave-oven procedure takes only 30 s and is useful in demonstrating mucin as well as mucin-containing cells. We found that this method facilitates frozen-section diagnosis.

Cryoultramicrotomy↗
PubMed1991

Morphology of lymph nodes in the resected rectum of patients with rectal carcinoma.

In 424 patients with rectal carcinoma the lymph nodes of resection specimens were investigated with computer-aided morphometry. Number and size of the lymph nodes and metastases as well as the morphological data of the follicular and paracortical hyperplasia were determined. The distribution of these lymph node parameters according to the anatomical localization of the nodes was also noted. The morphometrical analysis of the 12,957 lymph nodes showed that incidence of the metastases and the lymph node reactions depends on the localization of the nodes, and the lymph node reactions may be related to the tumor. Furthermore our data suggest that the detection of lymph nodes depends first of all on the carefulness of the pathologist, which can be supported by special procedures as step sections and fat clearing.

Adult↗
PubMed1989

Two programmes for examination of regional lymph nodes in colorectal carcinoma with regard to the new pN classification.

The new pN classification for colorectal carcinoma requires not only a statement on absence or presence of regional lymph node metastases but also, if present, a knowledge of the site and number of involved nodes. Subdivision of the fatty tissue with nodes adhering to the tumor resection specimen into two compartments is therefore the first step in pathological examination of lymph nodes. The methods for this as well as the different techniques used in searching for nodes and further histological processing of nodes are presented. We outline a minimal programme for pN classification in which step-wise sequence of examination reduces work load. An extended programme designed to answer special questions regarding lymphatic spread and surgical method is recommended only within the framework of special clinico-pathological studies.

Colorectal Neoplasms↗