[Necessary enlarged exeresis in surgery of gastric cancer].
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Biomedical subjects
Publications and source records attributed to V Cangemi.
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The authors report two cases of chylous ascites recently observed. After a wide review of the literature, they point out the rarity of this disease and its particular therapeutic aspects.
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Data of 111 patients with ductal carcinoma of the pancreas examined over a decade (1979-1989) at the 1st Department of Surgery, "La Sapienza" University of Rome, are presented. 21.6% of them underwent pancreatic resection and 40.5% biliodigestive diversion. Resectability was 26.5% for tumors of the head, 11.8% for tumors of the body and tail, nil for diffuse tumors. Overall operative mortality was 13.5%. Only stage I patients were shown to be resectable for cure and benefited from surgery with 21% probability of 5-year survival.
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The Authors report a case of leiomyosarcoma of the rectum. Recent literature is reviewed and some problems related to clinico-pathological, diagnostic and therapeutic aspects of this neoplasia are also discussed.
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The Authors report a case of Poland's syndrome formerly undergone reconstructive surgery with unsatisfactory results. Therefore, a new surgical reconstructive strategy having aesthetic purposes is illustrated.
The Authors report their experience in the application of local anesthesia during breast prosthesis implantation.
The Authors carried out a literature review on prognostic factors and current management of renal cell carcinoma. A significant factor influencing survival appears to be the extension of the primary tumor (T). The finding of no nodal involvement is not always a favourable prognostic factor if the tumor is no more confined. A perfect knowledge of the prognostic factors may be useful to identify those patients who need post-operative chemotherapy. Surgery is still the treatment of choice for renal cell carcinoma. Extensive lymphadenectomy does not influence long-term survival, nevertheless since there is no additional mortality or morbidity, it is considered useful for a correct staging and a better evaluation of long-term prognosis.
AIMS AND BACKGROUND: Bronchogenic carcinoma is the major cancer-related cause of death in patients aged 70 years and over, and its incidence is rising. The aim of our study was to compare the incidence and the prognostic effect of the parameters characterizing resected patients with non-small-cell lung cancer (NSCLC) when stratified by age. Of 283 NSCLC patients candidates to a long-term follow-up program and who underwent pulmonary resection in our Unit, 34 (12%) were older than 70 years. METHODS: All patients had been preoperatively selected to exclude those with severe or multiple organ system disease and staged in accordance with the UICC classification. RESULTS: When univariate and multivariate analyses were performed within the elderly group, exclusively epidermoid carcinoma and multiple tumor nodules emerged as independent poor prognostic factors (hazard risk, 5.77 and 7.33, respectively). In comparing the older and younger groups, a higher incidence of previous primary neoplastic disease (P = 0.001), epidermoid carcinoma (P < 0.05) and multiple tumor nodules (P < 0.001) was observed in the elderly. Postoperative death was similar (3% vs 4.8%) in the two age groups, as was survival expectancy when stratified by stage. However, univariate analysis showed that epidermoid carcinoma (P = 0.001) and pneumonectomy (P = 0.00001) had a worse outcome in the older early stage subset than in the younger group. When multivariate analysis was performed in all early stage patients, only lymph node involvement and multiple tumor nodules were independently related to survival (hazard risk, 1.82 and 3.76, respectively) and had a poor prognosis. In more advanced disease, elderly and younger patients had a similar outcome. CONCLUSIONS: Our results confirm that a patient's advanced age is not a risk factor in deciding on pulmonary resection, at least for stage I and II NSCLC, and suggest that in all patients, irrespective of age, stage and histologic cell type, the presence of multiple tumor nodules is the only true prognostic factor with a very low survival rate.