Predisposing factors in carcinoma of the colon.
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Biomedical subjects
Publications and source records attributed to P Sherlock.
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The mortality of spontaneous gastrointestinal perforation in 36 patients with cancer was 84% (30 patients). The main factors responsible for this included failure of recognition, perforation through tumor, advanced uncontrolled disease and multiple organ failure. Six of 19 patients who underwent surgery survived (32%). Five of these patients did not perforate through tumor and their underlying malignancy was in good control. Earlier diagnosis is essential. Prompt surgical intervention and intensive supportive measures are indicated only if additional therapy of the underlying malignancy offers a reasonable chance for continued worthwhile palliation.
Factors influencing diagnostic yield by directed endoscopic biopsy and cytology were studied in 50 patients with advanced gastric cancer using a forward-viewing panendoscope. The diagnostic yield was higher for exophytic lesions than for infiltrative tumor, and directed brush cytology alone was more productive than directed biopsy alone. The lesions that provided non-diagnostic tissue were mostly recurrent or infiltrative cancers, and were most often in the cardia, antrum, or were of the linitis plastica type. The combination of infiltrative character and location in antrum or cardia, especially if recurrent, often resulted in non-diagnostic biopsy and cytology specimens.
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