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At least 253 records · Page 14Linked to original sources

[Study on local recurrence in patients undergoing curative surgical resection of lung cancer].

Clinical features of recurrence in patients of lung cancer undergoing curative surgical resection were examined with special reference to the local recurrence. Subjects were 308 patients, consisting of 160 adenocarcinomas, 121 squamous cell carcinomas, 15 large cell carcinomas, 12 small cell carcinomas. They underwent curative resection in our department between 1973 and 1987. Local recurrence developed in 54 patients (18%). There was no significant difference in the incidence of local recurrence among the four histological types of carcinoma. According to the pathological stage, the incidence was 9% in stage I, 15% in stage II, and 35% in stages IIIA+IIIB. The local recurrence was subdivided into the following patterns: 1) lymphatic metastases to the hilar, mediastinal, or supraclavicular sites, 2) recurrence at the surgical margin, 3) malignant pleuritis or pericarditis, 4) so-called "endobronchial metastasis". The incidence of recurrence according to the patterns was 15%, 2%, 2% and 1%, respectively. The incidence of recurrence due to lymphatic metastases was correlated significantly with the pN factor but not with the pT factor. Patients with central type lung cancer showed a significantly higher incidence of lymphatic recurrence than patients with the peripheral type. Patients having postoperative radiotherapy to prevent local recurrence showed a lower incidence of lymphatic recurrence than patients having no radiotherapy. In conclusion, lymphatic recurrence was the most frequent pattern in local recurrence after curative resection of lung cancer, and therefore improvements in the operative procedure of lymphatic dissection, as well as in postoperative adjuvant therapy including radiotherapy will be urgently required for the purpose of reducing local recurrence.

Adenocarcinoma↗

[Factors in recurrence after curative resection of rectal cancer].

Data on 409 Patients who had a curative resection for rectal cancer at the National Taiwan University Hospital between 1977 and 1989 were analysed to determine the independent effect on recurrence. In our series, the total operative mortality rate was 1.7% and the resectability rate was 88.1%. For these cases who received curative resection, the overall 5-year survival rate was 62.6%. The 5-year survival rate varied according to the Dukes' stage: stage A, 96.4%; stage B, 73.3% and stage C, 39.6%. The total recurrence rate after curative resection was 35.9%, including local recurrence 18.3%, systemic recurrence 12.0%, and combined recurrence 5.6%. According to Dukes' staging system, the recurrence rate for stage A, B and C were 0%, 22.4% and 63.8%, respectively. We used Cox's regression model to analyse the patients characteristics and pathological variables on recurrence and to assess the independent influence of each when all other factors were held constant. The pathological stage of the cancer had the strongest association. Other variables found to have an independent yet significant importance, were CEA level and tumor size. The identification of the patient group, at a high risk of recurrence, might promote a more judicious selection for surgical procedure and trials of adjuvant therapy.

Adult↗

[High dose rate brachytherapy: a potentially curative treatment for small invasive T1N0 endobronchial carcinoma and carcinoma in situ].

INTRODUCTION: High dose rate brachytherapy (HDR-BT) is an option for treatment of small invasive endobronchial carcinoma and carcinoma in situ. This retrospective study describes the results of 33 consecutive patients treated with curative intent and followed up for more than one year. METHODS: Between July 1994 and October 1999, 35 tumours were treated with HDR-BT alone using a standard protocol delivering 6 fractions of 5 Gy delivered across 1cm from the catheters over 3 to 6 weeks. In 31 patients, surgical treatment was ruled out because of histology (in situ carcinoma), history of pneumonectomy or significant co-morbidity. Two patients were treated for positive resection margins following pneumonectomy. All the tumours were Tis or T1 N0. RESULTS: The locations of tumours were: trachea - 2, main bronchus - 5, lobar - 20, and segmental - 8. Only one catheter was needed in 15 cases, 2 in 13 cases, 3 in 6 cases and 4 in 1 case. The median follow-up was 17 months (range, 5-53 months). The recurrence-free rate was 94.3% at 2 months and 86.2% at 6 months after the treatment. 15 patients (45.5%) developed local recurrence at a median time of 9 months. Three patients developed metastases. The 1-year and 2-year overall survival rate were 71.4% and 53.8% respectively and specific survival rates were 69.4% and 59%. One patient developed an acute pneumothorax, and late complications included 6 infections and 12 bronchial stenoses. There were no episodes of haemoptysis nor lethal complications. CONCLUSIONS: With strict selection criteria, HDR-BT can be a curative treatment for early invasive or in situ endobronchial carcinoma without serious toxicity. It is therefore a good alternative treatment with curative intent for inoperable patients.

Adult↗

Treatment of locoregional recurrence after intentional curative resection of pancreatic cancer.

In order to analyze the results of treatment of patients with locoregional recurrence after intentional curative resection of pancreatic cancer, a retrospective study was performed. During the period 1978-1988, 108 patients underwent an intentional curative resection fo the pancreas. In 34 patients locoregional recurrence occurred, all within a period of three years (cumulative recurrence rate 56%). Sixty-eight percent of the patients presented with upper abdominal pain, and 62% with weight loss. Survival was significantly better (p = 0.02) in the group of 18 patients without distant metastases (1-year survival 22%) than in the 16 patients with distant metastases (1-year survival 0%). Five patients without proven distant metastases were treated by resection or chemotherapy. The mean survival was 33 months (range 6-74) in the treated group, and 4 months (0.4-7 months) in the untreated group, p = 0.002. In this retrospective study the longest survival was seen after radical resection of locoregional tumor recurrence. We therefore recommend that patients with locoregional recurrence without distant metastases after intentional curative resection of pancreatic cancer be treated.

Adult↗

[Comparison of curative effect between decompression and incision of endolymphytic sac].

OBJECTIVE: We compared the curative effect between endolymphytic sac decompression and incision of endolymphytic sac to explore a simple, effective surgical way with less complication. METHOD: 23 endolymphatic sac decompression and 22 incision of endolymphatic sac were performed routinely under general anesthesia. RESULT: 41 of 45 patients were followed up more than 2 years after the surgical procedure, 21 of which received endolymphatic sac decompression, while others received incision of endolymphatic sac. According to Chinese Meniere disease's diagnosis and curative effect standard evaluation criteria tried out in 1996, 13 got grade A(completely controlled), 4 got grade B (fundamentally controlled), 3 got grade C (partially controlled) while 1 got grade D (not controlled) among 21 patients who received endolymphatic sac decompression. The fully control rate is 61.9%. Among 20 patients who received incision of endolymphatic sac, 12 got grade A (completely controlled), 5 got grade B (fundamentally controlled), 2 got grade C (partially controlled) while 1 got grade D (not controlled). The fully control rate is 60%. CONCLUSION: There is no significant difference between endolymphatic sac decompression and incision of endolymphatic sac in curative effect,but endolymphatic sac decompression is more convenient,safe and has less complication compared with incision of endolymphatic sac. From this,we favor endolymphatic sac decompression in selection of surgical method.

Adult↗

Implications of compositionality in the gene ontology for its curation and usage.

In this paper we argue that a richer underlying representational model for the Gene Ontology that captures the implicit compositional structure of GO terms could have a positive impact on two activities crucial to the success of GO: ontology curation and database annotation. We show that many of the new terms added to GO in a one-year span appear to be compositional variations of other terms. We found that 90.2% of the 3,652 new terms added between July 2003 and July 2004 exhibited characteristics of compositionality. We also examine annotations available from the GO Consortium website that are either manually curated or automatically generated. We found that 74.5% and 63.2% of GO terms are seldom, if ever, used in manual and automatic annotations, respectively. We show that there are features that tend to distinguish terms that are used from those that are not. In order to characterize the effect of compositionality on the combinatorial properties of GO, we employ finite state automata that represent sets of GO terms. This representational tool demonstrates how ontologies can grow very fast, and also shows that small conceptual changes can directly result in a large number of changes to the terminology. We argue that the curation and annotation findings we report are influenced by the combinatorial properties that present themselves in an ontology that does not have a model that properly captures the compositional structure of its terms.

Computational Biology↗

Curative reoperation for recurrent cancer of the extrahepatic bile duct: report of two cases.

Local recurrence, following a resection for cancer of the extrahepatic bile duct, is usually incurable with second curative surgery being almost impossible. To determine the feasibility and significance of second curative surgery, our experiences are presented in this study. The medical records and clinical outcomes of two patients that underwent a re-resection for recurrent cancer of the extrahepatic bile duct were retrospectively reviewed. A 50-year-old female patient that had a recurrent disease at the intrahepatic and intrapancreatic bile duct, 66 months after a segmental resection of the bile duct for common bile duct (CBD) cancer, underwent a hepatopancreatoduodenectomy. A 29-year-old female patient had a recurrent tumor mass in the distal CBD, 28 months after a right hemihepatectomy and Roux-en-Y hepaticojejenostomy for a type IIIa Klatskin tumor, and underwent a segmental resection of the bile duct. The gross type of the above two cases was a papillary tumor. There was no operative mortality or morbidity. All patients are still alive after 46 and 9 months, respectively, without recurrence after the reoperation. It is concluded that a surgical re-resection is possible in selected patients with recurrent bile duct cancer, mostly of the papillary type. A primary operation for bile duct cancer should be performed with a wide surgical margin, and secondary curative surgery should be considered whenever possible in cases of recurrence.

Adenocarcinoma, Papillary↗

Risk factors of long-term survival and recurrence after curative resection of hepatocellular carcinoma.

BACKGROUND/AIMS: The independent risk factors contributing to long-term survival (> or = 10-year survival rate) and recurrence after curative hepatic resection for hepatocellular carcinoma (HCC) were evaluated. METHODOLOGY: The prognoses were retrospectively analyzed in 247 consecutive patients (187 men and 60 women) treated with curative hepatic resection for HCC and discharged from the hospital. Prognostic factors were evaluated by multivariate analysis using Cox's proportional hazards model. RESULTS: Multivariate analysis revealed that pTNM stage IV, indocyanine green retention rate at 15 minutes (ICGR15) of > or = 20%, tumor size of > or = 5 cm, and positive hepatitis B surface antigen were independent risk factors of overall survival. Stage IV and ICGR15 of > or = 20% were also independent risk factors of disease-free survival. CONCLUSIONS: pTNM stage and ICGR15 may be simple and useful predictors to improve long-term survival and recurrence after curative hepatic resection for HCC.

Aged↗

[Short-term curative effect of amifostine combined with rhEPO on aged patients wilh myelodysplastic syndrome].

The aim of this study was to investigate the curative effect of amifostine (AMF) combined with recombinant human erythropoietin (rhEPO) on the aged patients with myelodysplastic syndrome. Two aged MDS patients (one aged 91; another 86) were treated with amifostine and rhEPO over a period of 4 weeks. The results showed that a short-term curative effect was observed and transfusion interval was prolonged in both patients after 4 week treatment with 5 x 0.4 g AMF plus 3 x 6,000 U rhEPO per week. The reticulocyte count in MDS-RA patient returned to normal at first week of treatment and still remained in normal level for 4 weeks; leukocyte, hemoglobin and platelet values in peripheral blood of MDS-RCMD patient obviousby increased, the abnormally increased reticulocyte value displayed a decrease trend after amifostine plus rh-EPO treatment. In conclusion, amifostine plus rhEPO may have a good therapeutic effect for aged MDS patients, and its clinical long-term curative effect still needs further evaluation.

Aged↗

[Curative surgical treatment of inoperable pancreatic cancer after neoadjuvant therapy].

In the treatment of pancreatic cancer only curative resection increases the life expectancy. Radical resection is a high risk operation, but it can be performed with low peri-operational mortality in specialist surgical centres. At the time of diagnosis most patients are in stage (TMN of pancreatic cancer UICC 1997) III or IV, thus curative resection cannot be performed. Neo-adjuvant therapy shrinks the tumour in 60-70%, giving new hope for the patients. In this paper authors present two cases of pancreatic cancer resections. Palliative operations were performed in patients with inoperable pancreatic cancer. Later neo-adjuvant chemotherapy was performed--in these cases it meant chemotherapy--and after that a second, this time curative procedure was performed.

Adult↗

[The relation of lectin receptor's activity of hepatocellular carcinoma (HCC) with the recurrence after curative hepatectomy].

Recurrence is an important factor affecting the survival rate of patients with hepatocellular carcinoma (HCC) after curative hepatectomy. Twelve types of lectin receptors in 33 cases of HCC tissues were determined by avidin-biotin-peroxidase complex (ABC) method. The relationship between lectin receptors, HCC grading and recurrence time after curative hepatectomy was investigated. The results showed that tumor-free period of patients after the resection of HCC was not closely related to the size of resected tumors, their pathological gradings as well as most lectin receptors. However, tumors that recurred longer than two years after curative hepatectomy had Bandeiraea simplifolia agglutinin I (BSAI) receptors obviously fewer than those recurring within two years. It is suggested that BSAI receptors in tumor tissues might be a useful index in the prognosis of HCC patients after hepatectomy.

Adolescent↗

Evaluation of curative and palliative radiotherapy efficacy in extensive stage small cell lung cancer.

OBJECTIVE: To evaluate the efficacy of curative and palliative radiotherapy in the treatment of extensive stage small cell lung cancer (E-SCLC), and compare therapy effect on survival with or without metastatic disease. METHODS: From January 1998 through December 2004, 128 patients with E-SCLC were treated with radiotherapy and concomitants combined chemotherapy. Radical radiotherapy, consisting of approximately 60 Gy given in up to 30 fractions was performed in 53 (41.4%) of these patients. Others (58.6%) were treated with palliative dose radiotherapy. In all patients, chemotherapy was planned with cisplatin (80 mg/m2) intravenously (i.v.) on day 1, and etoposide (120 mg/m2) i.v. on days 1, 2 and 3, every 3 weeks for 3-6 cycles. Conventional follow-up of patients was conducted at Izmir Oncology Center, Izmir, Turkey. All results were evaluated statistically. RESULTS: One hundred and twenty-four patients (96.9%) were males. The mean age was 58.49 (+/- 9.01), ranging from 37-78 years. Metastases were initially determined in 64 patients (50%). The median follow up of patients was 287.41 days and median survival was 354.87 days. One year survival rate was 35.8%, and 2-year survival rates was 16.9% in the radical radiotherapy group, while these rates were 26.6% and 8% in the others. According to the statistical findings; the gains in duration of median survival with the curative thoracic irradiation are 151.97 days in all 128 patients. CONCLUSION: This study shows that curative radiotherapy at the primary tumor provides an additional survival benefit in patients with metastatic disease compared with palliative radiotherapy. This finding raises the question of whether treatment with radical thoracic radiotherapy with concomitant chemotherapy, consisting of first-line drugs, might be more beneficial and cost-effective as well as a less toxic treatment of E-SCLC.

Adult↗

Outcome and pattern of recurrence after curative resection for hepatocellular carcinoma in patients with a normal liver compared to patients with a diseased liver.

BACKGROUND/AIMS: The purpose of this study was to investigate whether differences existed in demography and outcome after resection for hepatocellular carcinoma (HCC) in patients with a normal liver compared to patients with a diseased liver. METHODOLOGY: Twenty-seven Caucasian patients with HCC in a histologically proven normal liver (NL group) in the Netherlands and 141 Asian patients with HCC in a diseased liver (DL group) in Japan underwent a curative liver resection. Patient and tumor characteristics, post-resectional disease-free, overall survival rates and pattern of recurrence were investigated. RESULTS: HCC's in the NL group were found to be larger, in a more advanced stage and needed more extended resections compared to HCC's in the DL group. Microvascular invasion was similar in both groups, while capsule formation was observed less in the NL group. Overall survival and disease-free survival after curative resection were not statistically different between both groups. Also even after stratification for T-stage, there was no difference in survival. Although the rate of recurrence was similar in both groups, a significantly higher number of extrahepatic metastases was observed in the NL group. CONCLUSIONS: Distinct demographic differences existed between patients with HCC in the NL group compared to patients in the DL group. Extrahepatic recurrences were more frequent after curative resection for HCC in a normal liver. No difference in survival was demonstrated between both groups.

Adult↗

[Analysis on the long-term curative effect of endoscopic sinus surgery].

OBJECTIVE: To analyze the long-term curative effect of endoscopic sinus surgery. METHOD: One hundred and twenty-eight cases (180 sides) of chronic sinusitis and nasal polyps were treated with FESS, 80 side (64 cases) were elected randomly to deal with the anatomical variation of middle and inferior turbinate and nasal septum during the operation (rectification group), comparing the curative effects with other 100 sides (64 cases) (contrast group). RESULT: Following up survey from 12 months to 24 months postoperatively, the curative effect in the rectification group was better than that in the contrast group. CONCLUSION: Dealing with anatomical variation that influence the nasal cavity function in FESS can significantly improve the healing rate of sinusitis and ventilation function and decrease the adhesions rate.

Adolescent↗

Prognostic factors of curatively resected esophageal carcinoma associated with multiple metastatic lymph nodes.

BACKGROUND/AIMS: Prognosis of esophageal carcinoma with multiple metastatic lymph nodes is dismal despite radical operation and adjuvant therapy. We investigated prognostic factors for curatively resected esophageal carcinoma with multiple positive nodes. METHODOLOGY: From January 1983 to December 2002, 343 patients with thoracic esophageal carcinoma underwent an esophagectomy with curative intent. Of these patients, 82 patients were associated with 4 or more histopathologically positive nodes. Of these patients, 59 patients underwent a curative resection. Of these 59 patients, 7 patients who died of postoperative complications during the hospital stay were excluded. Therefore, 52 patients were enrolled in this study. Survival curves were compared after stratifications according to 14 clinicopathologic variables. Independent prognostic factors were detected using a multivariate Cox proportional hazard model. RESULTS: The cumulative 5-year survival rate for the subjects was 10.6%. The factors affecting cumulative survival rate by a univariate analysis were intramural metastasis (absence vs. presence) (p=0.03), and postoperative therapy (performed vs. not performed) (p=0.02). A multivariate analysis detected the performance of postoperative therapy (Hazard Ratio= 0.390, p= 0.002) and the absence of intramural metastasis (Hazard ratio=0.429, p=0.01) as positive prognostic factors. CONCLUSIONS: The positive prognostic factors for esophageal carcinoma with multiple lymph node metastases were the absence of intramural metastasis and the performance of adjuvant therapy.

Adult↗

[Multivariate prognostic analysis for patients with curative resection of gastric cardia cancer].

OBJECTIVE: To explore the factors affecting the long-term survival of patients with curative resection of gastric cardia cancer. METHODS: The data of 108 patients who underwent radical resection of gastric cardia cancer from Jul. 1994 to Dec. 2003 in our hospital were investigated retrospectively. The Kaplan-Meier method and long-rank test were used for bivariate comparisons of survival. Multivariate analysis was done by the Cox regression model (Backward Wald). RESULTS: Survival status of the 108 patients was ascertained in Dec. 2004. Among them, 68 were Siewert type II and 40 were Siewert type III. Seventy-four patients had lymph node metastases (68.5%). The mean follow-up time was 37 months (95% CI: 29.3-44.7 months) and the middle follow-up time was 26.6 months (95% CI: 25.8-34.2 months). The 1-,3- and 5-year cumulative survival rates were 77.2%, 33.6% and 21.8%, respectively. According to the Kaplan-Meier and log-rank methods, splenectomy, lesion size, depth of tumor invasion and regional lymph node status were prognostic factors. Multivariate regression analysis indicated that only depth of tumor invasion (P=0.009) and lymph node metastases (P=0.001) were independent prognostic factors. CONCLUSION: Depth of tumor invasion and lymph node metastases have negative effects on the survival of patients with gastric cardia cancer undergoing curative resection. Splenectomy may only be appropriate for patients with direct tumor invasion to the spleen and the extent of gastric resection does not influence survival in patients with curative gastric cardia cancer.

Adult↗

[Contrast the curative effect of the improved UPPP and traditional UPPP in treating OSAHS].

OBJECTIVE: To compare the curative effect of the reserving soft palate and part uvula UPPP and traditional UPPP in OSAHS Patients. METHOD: Eighty-five OSAHS patients were selected and were performed two groups :improved UPPP (44 cases) and traditional UPPP (41 cases). The follow-up was carried out in 6 months and 1 year after operation, and the curative effects were compared. RESULT: The improved UPPP had been performed on forty-four patients and the traditional UPPP on forty-one patients. The total effective rate in improved UPPP group was 56.82% (25/44), in UPPP group was 58.54% (24/41)6 months later, there was no statistically significant difference between them (P > 0.05). The total rate of the postoperative complication in improved group was 36.36% (16/44), in traditional UPPP group was 68.29% (28/41) 6 months later, there was a statistically significant difference between them (P < 0.05). The total effective rate in improved UPPP group was 47.73% (21/44), in traditional UPPP group was 46.34% (19/41) 1 year later, there was no significant difference between them (P > 0.05). The total rate of the postoperative complication in improved UPPP group was 27.27% (12/44), in traditional UPPP group was 73.17% (30/41)1 year later, there was a statistically significant difference between them (P < 0.05). CONCLUSION: It may get identical curative effect to use improved UPPP and traditional UPPP for those oropharynx obstruction OSAHS patients. But improved UPPP may efficiently reduce the rate of the postoperative complication.

Adult↗

[A meta-analysis of the curative effects of carboplatin-based and cisplatin-based chemotherapeutic regimens on advance non-small cell lung cancer].

OBJECTIVE: To evaluate whether there is a difference in the curative effect of carboplatin-based and cisplatin-based chemotherapeutic regimens on advance non-small cell lung cancer (NSCLC). METHODS: The databases PudMed, CENTRAL, and Chinese biomedical database were retrieved by using the key words "non-small cell lung cancer" or "carcinoma, non-small cell lung" so as to search the materials about the randomized controlled clinical trials that had compared the curative effects of carboplatin-based and cisplatin-based chemotherapeutic regimens on advance NSCLC. A meta-analysis was conducted. RESULTS: Eighteen documents about randomized controlled clinical trials, including 6478 patients, from the retrieved 3531 documents accorded to the demand of enrollment. The overall response rates of the carboplatin-based and cisplatin-based chemotherapeutic groups were both 27% (RR = 0.93, 95% CI = 0.86 approximately 1.01, P = 0.10). Neither funnel plot nor rank correlation test regarding response rate indicated the existence of publication bias (chi(2) = 18.63, P = 0.63). The 0ne-year survival rate of the carboplatin-based regimen group was 36%, not significantly different from that of the cisplatin-based regimen group (35%, RR = 1.04, 95% CI = 0.93 - 1.17, P = 0.5). Sensitive analysis confirmed the non-existence of differences in the overall response rate and one-year survival rate between these 2 groups. CONCLUSION: The curative effects of the carboplatin-based and cisplatin-based chemotherapeutic regimens are similar. The choice of carboplatin or cisplatin depends on the toxicity of the drugs and the patients' tolerance.

Antineoplastic Combined Chemotherapy Protocols↗