[Prevention, recognition and treatment of neoplasm recurrences from the surgeon's viewpoint].
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The frequency and type of failures after 121 partial laryngectomies in patients treated for cancer of larynx during 10 years (1980-1989) were evaluated. Failures in treatment (in the from of a local and nodal recurrence, distant metastasis or second primary malignant tumour) were noted in 33 (27.3%) cases. The most often failure was local recurrence which had been observed in 24 (19.8%) patients. In 8 cases--32% of local recurrences they developed in time over 5 years after surgery.
The Authors report their experience on the incidence of anastomotic recurrence in 122 patients surgically treated with colorectal resection for cancer. The number of local recurrences (3 cases, that is 2.5%) is in the inferior range of what reported in Literature. Parameters that influence the local failure are: depth of tumor invasion, extension to adjacent organs and structures, presence of lymph node metastases (valuable with Dukes' modified staging). Type of operation and histologic grade do not seem to influence local recurrence. The Authors report the therapeutic choices adopted in the cases considered.
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PURPOSE: To report a case of bilateral papilloma virus-positive conjunctival intraepithelial neoplasm and the treatment results of using adjunctive interferon alpha-2b. METHODS: Case report and literature review. RESULTS: A 73-year-old man underwent subtotal excisional biopsy of the 270-degree gelatinous limbal lesion of the right eye to avoid creating a limbal deficiency and cicatricial change. Total excisional biopsy of the temporal elevated leukoplakic limbal lesion was performed on his left eye. Histology examination showed bilateral intraepithelial neoplasia, and human papilloma virus-16 and -18 were detected by polymerase chain reaction in both lesions. Two supplemental perilesional injections of interferon alpha-2b in the right eye were given, and the residual mass decreased in size gradually and completed clinical resolution 7 weeks following initial surgery. Although no recurrence was noticed in the right eye, recurrence of the conjunctival intraepithelial neoplasm lesion was noticed in the left eye. CONCLUSION: Adjunctive therapy might lower CIN recurrence rate, especially in extensive lesions, when surgical excision cannot ensure a tumor-free margin. Our bilateral case provided a good control example for the recurrence with or without adjunctive therapy.
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