[Proximal resection in treating cancer of the cardial portion of the stomach].
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Biomedical subjects
Publications and source records attributed to V I Stoliarov.
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Post-radiation changes were studied in 21 patients suffering from esophageal cancer who had undergone preoperative irradiation. The results of quantitative morphological analysis were compared with the data obtained from examination of 15 patients operated for tumors but unexposed to radiation. Tumor damage index proved to be 35.0% +/- 4. Mitotic index remained unchanged, while pathological mitoses in tumors increased four times after irradiation (62.0% +/- 5.8 as compared with 15.4% +/- +/- 4.4). They are mostly observed in the dispersion of chromosomes in metaphase. It is concluded that in order to adequately visualise radiation-induced damage to tumor, different morphological criteria should be used in its evaluation, depending on the length of post-irradiation period.
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The end results of surgical and combination (radiation + surgery) treatment of 85 patients with liposarcoma are compared. The 5-year survival rate following combination therapy proved to be much higher than after surgery (84 and 53.4%, respectively). Application of radiation improves the results for treatment of all histological types of tumor, polymorphocellular liposarcoma included. Indications of standard and concentrated dose-fractionated radiation should be determined by the size of tumor.
Fifty one patients with bone sarcomas (42 cases) and soft tissue sarcomas (9 cases) were subjected to interscapulo-thoracic amputation. Five year survival was noted in 42,5% of cases with primary bone sarcomas. The survival was dependent first of all on the histologic character of the tumor: it is higher in chondrosarcomas (50,2%) and lower in osteosarcomas (25,4%). Interscapulo-thoracic amputation is an obligatory but helpful surgical intervention.
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The data presented evidence that parietography is a valuable adjunct to routine roentgenological examination. One of the most complicated problems to be solved by this technic is whether the tumor invaded the adjacent structures, and also its relation to the surrounding tissues and mediastinal organs.
The investigation performed gave the impression that only early diagnosis of tumors in the retroperitoneal space of non-organic genesis could give the timely and radical treatment. The authors believe that the dynamic observation, diagnosis and surgical treatment of relapses will give considerably better remote results.
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The authors came to a conclusion that concentrated perforative radiotherapy is rather well borne by the patients, does not give any complications both during the operation and in the postoperative period. The postoperative irradiation does not represent an obstacle for the following restoration of the continuity of the digestive tract.
By means of an electronic computer various standard technics of irradiation for cancer of the middle esophagus are compared as to the basic dosimetry range with the schedule of irradiation, calculated according to the program of the optimum dosimetry level. The criterion of the optimum dosimetry level was the requirement of a minimum integral dose in patient's body under even irradiation of the tumor zone (circular area with a diameter of 6 cm) but not less than 80% of the dosage in the esophagus center. The technics under stude show that rotation irradiation through 360 degrees provide the nearest approximation to the optimum regime.
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The authors are analyzing 109 combined operations performed for cancer of the cardial portion of the stomach with and without involvement of the oesophagus. Both immediate and remote results of the treatment are analyzed. In order to increase the radical effect of operation in metastazing of cancer into the neighbouring organs and presence of metastases in the regional lymphatic nodes the combined operations are recommended.
In 1015 patients with various diseases of soft tissues the pathological process was localized in the anterior abdominal wall in 64 patients (6,3%): desmoids were found in 41 patients, sarcomas -- in 12, benign tumors -- in 5 and non-tumor diseases -- in 6 patients. Dissection of the tumor must be performed not less than 2 -- 3 cm further than the pulpated borders. When plasty with local tissues is not possible, it is expedient to employ synthetic (terylene) prostheses.
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