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Biomedical subjects

P Hermanek

Publications and source records attributed to P Hermanek.

At least 253 records · Page 14Linked to original sources
PubMed1976

[Results of surgical treatment of early carcinoma of the stomach (author's transl)].

From 1961 to 1975, 53 patients were operated on for early carcinoma of the stomach, 24 of the total of 57 cancer sites being limited to the mucosa, 33 having already infiltrated into the submucosa. Macroscopically, most of them were ulcerative carcinoma, while histologically the intestinal type predominated. The cumulative five-year survival rate (excluding hospital deaths) was 86.5%, while after "typical" carcinoma resection by the Billroth II procedure with removal of the greater and lesser omentum it was 100% for mucosal and 93% for submucosal carcinoma.

Adult↗
PubMed1976

Early metastases in regional lymph nodes and prognosis of malignant melanoma. Histological and clinical examinations in 104 lymphadenectomized patients.

In 104 malignant melanoma patients who underwent lymphadenectomy (67 females, 37 males), correlations were studied between histologically diagnosed lymph node metastasis, the type of malignant melanoma and the depth of invasion according to Clark, as well as other parameters. In 35.6% of the patients, metastases of the primary tumor were found in one or several regional lymph nodes. In about one third of the patients, the clinical and histological lymph node findings were proven to diverge. The female:male ratio of generally about 2:1 shifted to 1:1 in the group of patients with lymph node metastasis, i.e. cases with lymph node metastasis were found significantly increased in the male sex, and also, when primary tumors were localized on the trunk. A prognostic correlation between the two parameters, sex and localization, is suggested by the high incidence of histologicallly diagnosed metastases in 1 or 2 lymph node regions, when malignant melanomas were localized on the trunk in males. As to the types and the micro-stages of primary tumors, the number of cases collected until now does not permit establishing clear correlations with the incidence of lymph node involvement. Calculating the 5-year-survival rates for patients with and without lymph node metastasis according to the "actuarial method", we found the prognosis to depend largely on the presence or absence of lymph node involvement, even at a time as early as at primary tumor excision. Our results support the indication for prophylactic lymphadenectomy in malignant melanoma, provided the primary tumor has reached or surpassed the micro-stage 3.

Female↗
PubMed1976

[Nodular fascitis].

Since 1971 four cases of Fasciitis nodularis were treated by the outpatient-department of the Surgical Clinic, Univ. of Erlangen. Alieno loco one patient's disease had been diagnosed as sarcoma, another patient had a lesion operated on which had been suggested being malignant by a pathologist. The danger in Fasciitis nodularis is, that it is easily considered a malignant process and therefore too radical a tumor therapy is performed. The differential diagnosis from clinical and histological point of view between Fasciitis nodularis and soft tissue tumors is presented.

Adult↗
PubMed1976

[Treatment of malignant melanoma (clinical stages I and II) (author's transl)].

The uncorrected cumulative five-year survival rate ("actuarial method") among 195 patients with infiltrative malignant melanoma of the skin was 58% (160 cases) in clinical stage I, 26% (35 cases) in clinical stage II. In addition to clinical staging, microstaging - i.e. the histologically determined depth of invasion of the primary tumour - is of great prognostic significance. In microstages 2 and 3 with the largest vertical tumour diameter below 0.76 mm, five-year survival rate was 100% while in microstage 3 with greater vertical tumour diameter it was 66% in microstage 4 55% and microstage 5 31%. Results of treatment can be reliably interpreted only if they are divided according to microstage. Propylactic dissection of the regional lymph-nodes (dissection in clinical stage I) need not be undertaken in microstages 2 and 3 with vertical tumours diameter below 0.76 mm. Whether prophylactic dissection was done in one or two sessions has apprarently no significant influence on survival rate. A single X-radiation dose to the primary tumour of 4 000 -6000 R immediately before excision of the tumour did not significantly increase the results. The results were particularly bad when the primary tumour was removed after inadequate manipulation.

Adult↗
PubMed1976

Combined staging and grading of renal cell carcinoma.

After surgical removal of renal cell cancers we can compare and contrast 3 prognostically differing groups by combining staging after Robson and histologic grading of malignancy. Good cancers (grade 1, stage I or II) have an (uncorrected) 5-year-survival rate of 93%, bad cancers (grade 3, Robson stage II or III) one of 35%. The remaining tumors (intermediate cancers) have a 5-year-survival rate of 64%. Classification in 3 groups is also advisable for future comparison of end result reports.

Adenocarcinoma↗
PubMed1976

Renal cell carcinoma--invasion of veins.

Out of 188 operatively removed renal cell carcinomas 49% showed macroscopic evidence of vein invasion and in 28% of the cases only histologically provable vein invasion. The uncorrected 5-year survival rates amounted to 40.8% in macroscopic vein invasion, 60.6% in histologically provable vein invasion and 75.6% in the absence of vein invasion. The term 'vein invasion' should therefore always be defined more precisely. Hence suggest to modify the V classification of 1974 of the UICC.

Adenocarcinoma↗
PubMed1976

Histological grading of renal cell carcinoma.

The Erlangen system of histologic grading of the malignancy of renal cell cancers is described in detail. It takes into consideration the type of cell and pattern of the tumor and differentiates between grades 1, 2, and 3. Grade 1 was observed in 10%, grade 2 in 51%, and grade 3 in 39% of the cases. The difference in the 5-year survival rates between tumors of grade 3 and those of tumors of grades 1 and 2 is statistically significant.

Adenocarcinoma↗
PubMed1976

[Malignant melanoma: depth of invasion and histologic typing].

INTRODUCTION: In classifying a malignant melanoma Clark et al. (1969) have suggested histologic typing (lentigo maligna-melanoma, superficial spreading melanoma, nodular melanoma) as well as the determination of the depth of invasion. The experiences made so far need further confirmation through respective research in additional material. This applies to the frequency of histologic types of melanoma and the microstages and primarily to the prognostic significance. There appear to be correlations whether the depth of invasion or the type of melanoma is decisive for prognosis or whether both have to be considered. MATERIAL AND METHODS: Between 1967 and 1974 the depth of invasion and the type of melanoma were determined according to Clark et al. (1969) in 139 invasive malignant melanomas. This classification has been carried out routinely following the excision of the tumor since Jan 1st, 1973; in previously operated tumors it was carried out in retrospect without knowledge of the follow-up. Without exception multiple sections of several blocks were used. Uncorrected survival curves and survival rates were drawn up using the acturaial method. Results 1. Of 139 malignant melanomas 3 (2%) were found to be in microstage 2, 50 (36%) in microstage 3, 71 (51%) in microstage 4 and is (11%) in microstage 5. 2. The type of 2 melanomas could not be defined. Among the remaining invasive malignant melanomas 17 (12%) were lentigo maligna melanomas, 48 (35%) were superficial spreading melanomas and 72 (53%) nodular melanomas. 3. Of the 72 nodular melanomas 53 (74%) were found in microstage 4 or 5; of the 65 other melanomas (lentigo maligna melanomas or superficial spreading melanomas), however, only 34 (52%) p less than 0,001) were in this stage. 4. The uncorrected 5-year survival rate was 100% in microstage 2 and 3 and in tumours diameter of 0.76 mm or more, 55% in microstage 4 and 31% in microstage 5. 5. At equal depth of invasion there are no significant prognostic differences between the various types of melanomas. DISCUSSION: It was possible to reproduce the type classification of melanomas as introduced by Clark et al. (1969) in our own material from 139 patients. Tumors of microstage 2 were less frequent in our material (2%) than in American and Australian series (17-28%). As far as the frequency of the types of melanoma and the correlation between the type of melanoma and depth of invasion are concerned, the Erlangen material does not show considerable deviation from the reports in the literature on the subject. Among tumors of equal depth of invasion the type of melanoma has little prognostic impact. The depth of invasion is decisive for the prognosis. It can be determined with little effort to a high degree of reliability.

Humans↗
PubMed1976

Clinical conference: Unusual course of chronic colitis.

Case presentation of a 35-year-old patient with a history of chronic colitis of 16 years duration. Crohn's disease in this patient involved the entire colon without skip lesions and without terminal ileitis. The course was complicated by recurrent erythema nodosum and wandering arthritis as well as sclerosing cholangitis and multifocal adenocarcinoma of the large bowel. Sclerosing cholangitis is a rare condition in Crohn's disease (1,8) whereas pericholangitis in liver biopsy specimen was diagnosed in prospective studies in 8 (7) to 30 (2) per cent. The same is true for carcinomas complicating granulomatous enterocolitis. In a recent review 36 cases of small bowel cancer (4) and 20 cases of colon cancer (5) were reported. Weedon et al. (9) calculated the risk of developing carcinoma to be 20 times greater in Crohn's enterocolitis than in a control population. Using life-table methods the 10-year probability of remaining cancer free was 99.7 per cent, the 20-year probability 97.2 per cent. In our patient the long-lasting history of Crohn's colitis with several minor complications and the multiplicity of colonic carcinomas speak in favor of a causal relationship between the chronic inflammation and the development of malignancy.

Adenocarcinoma↗
PubMed1975

[Exploratory laparotomy and splenectomy in lymphogranulomatosis (author's transl)].

Exact determination of the extent of the disease is necessary for optimal treatment of lymphogranulomatosis. To this purpose 53 patients with lymphogranulomatosis had an exploratory laparotomy and splenectomy (42 adults and 11 children). On the basis of the operation results the pre-operative staging had to be revised in 14 patients and the treatment plan had to be changed in most cases. Lymphogranulomatosis of the spleen was demonstrable in 27 cases. Histologically the mixed-cell type was most commonly seen in the spleen. The size of the spleen was an unreliable diagnostic parameter as regards involvement with lymphogranulomatosis. In approximately a third of the adults with involved spleens the weight of the spleen was under 200 g. Hodgkin involvement of the liver was demonstrable in three patients; in these three cases splenic involvement coexisted. In seven patients post-operative complications occurred.

Adolescent↗
PubMed1975

[Gastric polyps: prognosis and treatment].

49 patients, previously treated for epithelial gastric polyps by resection or excision, were re-examined up to 22 years later. Except for those who had died of other diseases, in five histologically confirmed and in one a probable (radiologically) gastric carcinoma had been found. Three cases of gastric carcinoma without symptoms were discovered in the course of endoscopic follow-up examination. Two of these patients underwent radical operation (early carcinoma), while the third one proved to be inoperable. It is concluded that gastric polyps must be removed endoscopically or operatively and examined histologically: simple observation must be rejected. If the polyp is hyperplastic, local removal is sufficient. If there is a pure adenoma, two-third resection is essential. This is also true of hyperplasiogenic polyps if they are present in large numbers, while polypectomy is sufficient if solitary. Polyposis usually requires subtotal or total resection. Each patient with such polyps is exposed to a higher risk of gastric carcinoma. For this reason annual endoscopic control is necessary even if there are no symptoms.

Biopsy↗