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Biomedical subjects

R C Marcove

Publications and source records attributed to R C Marcove.

At least 73 records · Page 4Linked to original sources
PubMed1977

Juxtacortical (parosteal) osteogenic sarcoma: histological grading and prognosis.

In twenty-four cases of juxtacortical osteogenic sarcoma, three histological grades of malignancy were identified and correlated with the prognosis. The eighteen patients with Grade-I or II tumors had a significantly better prognosis than the six with Grade-III lesions. The three grades could not be distinguished roentgenographically. Grade I and II tumors, which showed a high cure rate after amputation, may be amenable to en block resection, provided the entire tumor can be removed with a good margin of uninvolved soft tissue and underlying bone. Grade-III tumors, on the other hand, had a poor prognosis despite early radical surgery.

Adolescent↗
PubMed1977

Radical resection for osteogenic sarcoma of fibula with preservation of the limb.

This is a report of a 15 year old girl with osteogenic sarcoma of the proximal fibula treated by en bloc radical excision without amputation of the limb. The anatomical individuality of the fibula, vascularization of the leg and effective adjuvant chemotherapy determined the feasibility of the procedure. There is no evidence of tumor recurrence 27 months after surgery.

Adolescent↗
PubMed1977

En bloc resection for osteogenic sarcoma.

Preservation of a limb without sacrifice of the principles of cancer surgery is desirable in young people with osteogenic sarcoma. At present amputation is generally regarded as the only well-established curative treatment for this condition. To determine whether en bloc resection with intensive chemotherapy is a realistic alternative to radical amputation and chemotherapy, 43 patients who underwent en bloc resection for osteogenic sarcoma of the distal femur (20 patients), proximal tibia (11 patients), shoulder girdle (11 patients) and fibula (1 patient) were studied. After tumour resection, chemotherapy and pulmonary resection 32 (74%) of the 43 patients are alive and 20 (67%) have no evidence of distant disease. Of the 38 patients without metastatic disease at the time of admission (5 were admitted with pulmonary metastases) 24 (63%) are alive without evidence of disease and without having had postoperative metastases.

Adolescent↗
PubMed1977

Primary osteogenic sarcoma: pathologic aspects in 20 patients after treatment with chemotherapy en bloc resection, and prosthetic bone replacement.

Twenty patients with osteogenic sarcoma of the distal portion of the femur and the proximal portion of the tibia received chemotherapy (vincristine sulfate, methotrexate with leucovorin calcium rescue, [citrovorum factor; folinade calcium], and doxorubicin hydrochloride [Adriamycin]), followed by radical en bloc resection and prosthetic bone replacement. Histologic examination of surgical specimens obtained after chemotherapy showed variable degrees of tumor destruction and, in some cases, massive tumor necrosis, attesting to the profound effects of vigorous chemotherapy. This new therapeutic regimen, when feasible, may prove to be the treatment of choice in osteogenic sarcoma.

Adolescent↗
PubMed1977

Ewing's sarcoma -- functional effects of radiation therapy.

Long-term morbidity was assessed in fifty-five patients with Ewing's sarcoma who survived two years or longer. Primary site, radiation dosage, and age of the patient all had an important bearing on the end result. Guidelines for treatment of the primary tumor were developed. Patients with upper-extremity lesions were generally best treated by radiotherapy. Young children and some of the older patients with lesions in the lower extremity were generally best treated by primary amputation, depending on the site of the lesion.

Adolescent↗
PubMed1977

Cryosurgery in the treatment of bone metastases from renal cell carcinoma.

Solitary metastasis is uncommon, occurring in 1.6% to 3.2% of patients with renal cell carcinoma. Because of the potential of survival, amputation of an extremity with a metastasis is frequently advocated, particularly after successful nephrectomy. The cure rate with amputation is approximately 30%. Cryosurgery for treatment of localized and limited bony metastasis in an alternative to more radical surgery. This is a report of follow-up observation of the original series of cases as well as the addition of 4 new cases with multiple metastasis.

Adenocarcinoma↗
PubMed1976

Chemotherapy, en bloc resection, and prosthetic bone replacement in the treatment of osteogenic sarcoma.

In an attempt to shrink primary osteogenic sarcoma and allow complete surgical removal of the primary tumor, without amputating the involved limb, intensive preoperative chemotherapy with high dose methotrexate (HDMTX) with citrovorum factor rescue (CFR) and adriamycin (ADR) was initiated in 20 patients with biopsy-proven primary osteogenic sarcoma of the distal femur (15 patients) and proximal tibia (five patients). Following intensive chemotherapy, en bloc resection of the primary tumor with prosthetic replacement of the involved bone was planned. After surgery, adjuvant chemotherapy, consisting of HDMTX with CFR, ADR, and high dose cyclophosphamide was given sequentially for 1 year. Of 20 patients with primary osteogenic sarcoma (two with evidence of pulmonary metastases), 18 had primary tumors that could be clinically measured. Of these 18, 17 demonstrated a decrease in the size of primary tumor prior to surgery, while on chemotherapy. To date, 12 of these patients with osteogenic sarcoma of the distal femur have had total femur and knee joint replacement, and three patients with osteogenic sarcoma of the proximal tibia have had total knee replacement. In all 15 patients, surgical margins were grossly and microscopically free of tumor. There has been no evidence of soft tissue recurrence in any of the 15 patients who have undergone surgery for from 2 to 15 months postoperatively. These preliminary results indicate that with the use of aggressive chemotherapy, it is possible to demonstrate objective tumor regression in primary osteogenic sarcoma, allowing the surgeon to perform en bloc resection of tumor and prosthetic replacement of the involved bone. Although the limb is preserved, it is important to stress that extensive surgery yielding tumor-free margins is performed. The ultimate evaluation of this approach to the treatment of primary osteogenic sarcoma awaits longer observation, to determine limb function and the continued disease-free status, once adjuvant chemotherapy is discontinued.

Adolescent↗
PubMed1975

The treatment of pulmonary metastasis in osteogenic sarcoma.

The survival times in a control series of 145 cases of osteogenic sarcoma without pulmonary resections including records of pulmonary nodules and surgical wedge excisions, suggest that pulmonary resection is a noteworthy adjunct treatment. The 5-year survival of patients subjected to repeated pulmonary surgery is known for 22 patients who were under the age of 21. Where aggressive pulmonary resections were performed, i.e., repeated thoracotomies, and multiple wedge resections of nodules, a 5-year survival rate of 31 per cent (after date of primary amputation) is noted and compared to a previous study of 145 cases, 121 of which had untreated pulmonary metastases, and at 5 years, only 2 per cent of these patients with metastases were still alive. Lung wedge resection survivals are highly significant statistically although survival with residual disease must be considered in part at least, due to aggressive chemotherapy (i.e., high dose methotrexate with citrovorum rescue in combination with other drugs).

Bone Neoplasms↗
PubMed1975

Neoplasms of the shoulder girdle.

The author has briefly discussed radiation therapy, immunotherapy, and chemotherapy in the treatment of some of the more commonly encountered disease entities affecting the shoulder girdle. Specific operations and their indications are discussed. However, utilizing physical and x-ray examination, arteriography, lymphangiography, and bone scan information, the surgeon may decide that the routine operation is not indicated for a particular tumor problem. He should be able to be flexible and to modify the operation according to the specific presenting problem and not be bound by routine fixed rules. In this way the patient can be assured of the very best treatment.

Adult↗
PubMed1975

Adamantinoma of long bones. A clinicopathological study of fourteen cases with vascular origin suggested.

Adamantinoma of long bones is a rare primary bone tumor. Approximately 100 cases have been reported in the literature. In the fourteen cases we studied in detail the ages of the patients ranged from thirteen to sixty-seven years and there were as many males as females. Twelve of the lesions were located in the tibia and two, in the humerus. The roentgenographic findings were sharply defined eccentric lobular lesions in the diaphysis. Some of the lesions were lytic and coarsely trabecular with a honeycomb appearance occasionally associated with periosteal new-bone formation. A sawtooth area of cortical-bone loss was found to be characteristic of this lesion. A microscopic finding is presented to support the theory of angioblastic origin of this tumor. The most successful treatment was amputation. Less often en bloc excision succeeded. Metastases to other bones, regional lymph nodes, and the lung were recorded.

Adolescent↗