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Biomedical subjects

P Hermanek

Publications and source records attributed to P Hermanek.

At least 55 records · Page 3Linked to original sources
PubMed1998

[A critical analysis of different outcomes in surgery of colon carcinoma].

Five-year survival rates following colon carcinoma surgery are influenced by (1) type of survival rate calculation (observed, adjusted or cancer-related, relative or age-corrected), (2) definition of carcinoma (inclusion of Tis or high grade dysplasia?), (3) distribution of proven prognostic factors, in particular R, pTNM, grading and surgeon, and (4) carefulness of histopathologic tumor classification. The impact of the surgeon, i.e. the quality of surgery, is now proven by multivariate analysis. In adjuvant treatment studies, quality assurance of surgery and pathology is indispensable.

Colonic Neoplasms↗
PubMed1997

Multiple simultaneous gastric carcinomas.

A total of 1664 patients with gastric cancer were examined to evaluate the rate of multiple synchronous primary tumours. In cases of multiple synchronous cancer (MSC), the tumours were analysed immunohistochemically for their expression pattern of p53, c-erbB2, ras, E-cadherin and proliferative activity. Multiple synchronous gastric carcinomas (MSCs) were observed in 61 out of 1664 patients (3.7%), with a total of 134 carcinomas. In our series, early carcinoma was observed more frequently in MSC than in solitary cancers. The comparison of tumour stage in MSC and solitary tumours revealed that multiple early gastric cancers were significantly more often of type I (protruded type) and IIa (superficial elevated type) than solitary early cancer. Multiple advanced carcinomas were more often of a lower pT category than solitary advanced gastric cancer. Performing immunohistochemistry for p53, c-erbB2 and ras in 134 tumours with MSCs, we observed positivity rates of 33%, 59% and 87% respectively. In 43 patients, the multiple tumours in each individual patient demonstrated an identical status of p53 and c-erbB2, and in 42 patients a similar pattern of E-cadherin expression was observed. The proliferative index, determined by proliferating cell nuclear antigen (PCNA) immunolabelling, did not differ significantly between the MSC in each patient. Ras immunostaining was detected in 53 out of 61 patients, but also in metaplasia and regenerative hyperplasia in the specimens. In survival analysis, no difference was observed between patients with solitary or multiple early or advanced carcinomas. Our results suggest that in at least a high proportion of patients with gastric cancer multiple primary tumours arise from precancerous conditions leading to similar genetic alterations.

Aged↗
PubMed1997

International documentation system for pancreatic cancer (IDS). The future in pancreatic cancer evaluation.

Different classification systems for pancreatic cancer have evolved in western countries as compared to Japan. While the UICC classification which is focused on tumour size and distant metastasis has achieved widespread acceptance, the more complicated Japanese system seems to be superior in the estimation of local growth. The major drawback of the JPS system, however, is the complex structure and difficult handling. To overcome both the international barriers in classification systems and to achieve a universal prospective data acquisition, a uniform international Documentation System for Exocrine Pancreatic Cancer (IDS for EPC) has been developed by an international group of pancreatologists. The present form of IDS is supported by a software program (based on Microsoft Access) which allows simplified data acquisition and statistical analysis as well as automated stage grouping for the UICC and JPS classifications. From the first contact with the patient, through all diagnostic and therapeutic measures including follow-up, IDS enables a compact and easy-to-use tool for prospective data acquisition and exchange on an international basis.

Documentation↗
PubMed1997

[Prognostic factors in malignant tumors--significance for quality management].

In a relevant quality management, the long-term prognosis as the definite criterion has to be the focus of interest for the assessment of outcome quality (2). Only with the knowledge of the long-term course by the means of the total survival, the adjusted cancer-related and tumor-free survival it can be assessed, how much a hospital accomplishes in the treatment of cancer. However, not only the treatment is of importance for the outcome, but also a multitude of different parameters mainly regarding the tumor itself but also concerning the patient have to be considered in the assessment of the results. Treatment outcomes can only be compared with the knowledge of these prognostic factors and this is the importance of prognostic factors for quality management.

Combined Modality Therapy↗
PubMed1996

Correlation of polypoid lesions in the distal colorectum and proximal colon in asymptomatic screening subjects.

OBJECTIVE: Knowledge of a possible correlation between distal polyps found at screening sigmoidoscopy and proximal colonic lesions is important for deciding whether to perform total colonoscopy or not. PATIENTS: A prospective analysis of 2439 consecutive patients with colorectal polyps. Of these, 304 were asymptomatic subjects who underwent complete colonoscopy for screening and were found to have adenomatous or hyperplastic polyps in the distal colorectum. RESULTS: Ten (15%) out of 65 patients with distal hyperplastic polyps only and 86 (36%) out of 239 with distal adenomatous polyps were found to have adenomatous polyps in the proximal colon as well (P < 0.001). The frequency of synchronous proximal adenomas in patients with small (< or = 5 mm) or large distal adenomas (> 5 mm) was comparable (37% and 35%, respectively). However, patients with small distal adenomas had significantly smaller proximal adenomas (P = 0.004) containing less villous component (P = 0.017) than those with large distal adenomas. Neither the patient's age nor the presence of multiple distal adenomas increased the prevalence of proximal adenomas. CONCLUSION: Hyperplastic polyps found on rectosigmoidoscopy do not indicate a need for a complete colorectal examination, as 15% of patients with distal hyperplastic polyps will have proximal adenomatous polyps, a figure that is comparable with that of asymptomatic patients having no distal polyps, either hyperplastic or adenomatous. When only small distal adenomas are found at screening sigmoidoscopy in asymptomatic persons the decision to do a total colonoscopy should be based on individual considerations, as in such cases only small polyps are to be expected in the proximal colon.

Adenomatous Polyps↗
PubMed1996

[Differential surgical procedure in curative therapy of stomach carcinoma].

The principle of histology-and stage-oriented cancer treatment generally adopted in modern oncology is realizable and desirable also in surgery for stomach carcinoma. Instead of a single standard operation for all gastric carcinomas surgical procedure should be individualized. Curative local therapy as endoscopic polypectomy or mucosal resection or laparoscopic intraluminal surgery is possible only in a limited number of patients. In all other patients radical resection is indicated, either as subtotal distal gastrectomy or as total gastrectomy, if necessary with extension to adjacent organs. The radical resection includes a radical lymphadenectomy (D2 dissection). Its extent should be adapted to the individual situation by consideration at least of tumor site. Preferable is the use of a pretherapeutic computer model which calculates the probability of metastasis to the various lymph node groups considering additional factors with influence on lymphatic spread.

Endoscopy↗