Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Curated”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 595 records · Page 33Linked to original sources
PubMedDate not supplied

[Pelvic recurrences after curative surgery for rectal cancer].

This report updates an experience with local recurrences of rectal cancer after curative surgery. Overall 13 year period (1976-1988) 254 patients were operated on in the II Surgical Clinic of Parma University for rectal cancer. Only 122 patients who underwent potentially curative resection were examined. Approximate recurrence rates according to patients age, site, type and stage of primitive tumour, tumour complications and surgical procedures were evaluated. The overall local failure rate was 17.2% with 12 patients having local failure alone and 9 patients having concurrent local failure and distant metastasis. Local failure occurred predominantly in tumour bed, involving the anastomosis in 2 cases. Relapse developed primarily at colo-rectal anastomosis in only 1 patients, 20% of recurrences were diagnosed within the first postoperative year; 65% within the second and 90% within the third. Stage of primary tumour was the most predictive factor for eventual relapse. Minute foci of tumour not encompassed by the first operation led to local recurrences in most of the cases, but relapses were independent of operative procedures adopted. The authors conclude that surgery, even if correctly performed, is not sufficient to prevent the risk of local recurrence of rectal cancer. They believe that routine adjuvant radiation therapy after surgical treatment of rectal cancer should improve survival rate.

Age Factors↗
PubMedDate not supplied

[Locoregional recurrences following curative surgery for colon cancer].

This study explores the patterns of local recurrence after curative operations for colonic cancer. Over a 13 year period (1976-1988) 486 patients were operated on in the Surgical Clinic of Parma University for colonic cancer, but only 296 patients who underwent potentially curative resection were examined. The influence of patients' age, disease stage, site and grade, presence of obstruction or perforation and type of surgical procedures were examined as prognostic factors for local cancer recurrence. A total of 28 patients (14%) relapsed after surgery and 19 were found to have simultaneous distant metastasis. 86% of recurrences were evident within the first 2 years. Local recurrence rate increased with more advanced Duke's stage and stage of the primary tumour was most predictive for eventual relapse. The recurrences occurred within the operative resection site involving the anastomosis by inward growth at the suture line. Minute foci of adenocarcinoma not encompassed by the first operation might lead to local recurrences; the authors do not rule out, however, the rare possibility of the implantation of exfoliated malignant cells. Despite the attempt to carry out an intensive followup in terms of early diagnosis of recurrence in colonic surgery, the presence of local recurrences is associated with extremely poor prognosis independent of operative procedure performed. The authors believe that routine adjuvant radiation therapy after surgical treatment of locally advanced colonic cancer could improve survival rate.

Age Factors↗
PubMed1978

Circulating immune complexes in patients following clinically curative resection of colorectal cancer.

Sixty-nine patients have been followed prospectively after curative resection of Dukes-Kirklin B-2 or C colorectal cancer. Serial plasma samples were studied in selected patients to determine changes in circulating immune complex concentrations (CIC) following primary tumor resection, and to compare serial plasma CIC and carcinoembryonic antigen (CEA) levels. CIC was determined in an average of seven serial samples per patient by inhibition of antibody-dependent cell-mediated cytotoxicity (ADCC). CEA assays were performed by the Hanson Z-gel method. Two distinct patterns of serial CIC have emerged. In seven patients with no known tumor recurrences, serial CEA levels and CIC oscillated regularly and were inversely related. In seven of eight patients whose tumors recurred, both CEA and CIC rose together. In three patients with elevated plasma CEA levels due to inflammatory bowel disease, serial Ag-Ab complex concentrations did not vary, nor did separated Ag or Ab fractions inhibit ADCC. These data suggest that, in patients following curative resection of colorectal cancer, serial changes in circulating immune complexes may discriminate between transient CEA elevations which occur despite no known tumor recurrence and tumor recurrence which is beyond the capacity of adequate host antitumor defense.

Adenocarcinoma↗
PubMedDate not supplied

[Low anterior resection in the curative surgical treatment of rectal cancer].

Abdominoperineal resections for rectal cancer are being performed with decreasing frequency in favour of sphincter-saving resections. It remains to be demonstrated that sphincter preservation has not resulted in compromised local disease control, disease-free survival and survival. For this purpose 315 patients with rectal carcinoma have been studied. In 44 cases (13.9%) it was only possible to perform a colostomy; a curative resection has been carried out in 206 (65.3%). Sphincter-saving procedure was performed whenever possible: the length of margin of resection was at least 2 cm. The operation were: 61 abdominoperineal excisions (AP), 135 anterior resections (AR), 10 transanal excisions (excluded from this analysis). The distribution of tumors in the various Duke's stages was: Dukes A--28 patients, Dukes B--143, Dukes C--35. The thirty-days mortality was 6 patients (9.8%) for AP and 6 (4.4%) for AR. Local recurrence was: AP 9 cases (16.1%), AR 16 cases (12.4%); for tumors 4-8 cm from anal verge recurrence was 18.7% for AP, 17.1% for AR. Concerning staging, local recurrence was more common in the Dukes C stage (36%) than in the Dukes B (11.2%) or in the Dukes A (3.7%). 5 years survival after AP was 54.6 percent and after AR 57.9 percent. Concluding, in our experience, there was no significant relationship between local recurrence or survival and type of curative surgery (AP or AR). Local recurrence and survival were only related to tumor stage (p less than 0.01): lateral tumor extension in these advanced and aggressive lesions appears to be the major determinant of local recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Long-term morbidity after curative radiotherapy for carcinoma of the bladder. A retrospective study.

48 patients with muscle invasive bladder cancer were asked by a mailed questionnaire concerning post-radiotherapy functional status, urological and intestinal complaints. All patients had received curative pelvic irradiation (greater than or equal to 1750 reu) nine to 133 months prior to the investigation. Eleven patients had recurrent or persistent disease and four (36%) of these patients had severe hematuria. The urinary morbidity of the 37 patients without evidence of disease varied between 24 and 38%, but only 3 to 8% of these patients experienced severe disturbances. Four patients (9%) had to undergo bowl resection due to severe radiation damage in the intestines. In conclusion, slight morbidity after curative radiation treatment is to be expected in about 30% of patients surviving more than six months. Severe complications may be expected in 10% of the patients. Serious complaints from the urologic tract, especially hematuria, indicate recurrent or persistent disease rather than a late radiation effect.

Female↗
PubMed1990

Time to recovery of the hypothalamic-pituitary-adrenal axis after curative resection of adrenal tumors in patients with Cushing's syndrome.

The recovery time of the hypothalamic-pituitary-adrenal (HPA) axis after curative resection of adrenal tumors in patients with Cushing's syndrome is poorly documented. Eight consecutive patients were treated with a standardized hydrocortisone replacement strategy after curative resection of a cortisol-secreting tumor and the time to recovery of the HPA axis was determined. Hypercortisolism was documented by elevated 24-hour urinary free cortisol levels. Cure was documented by undetectable postoperative morning serum cortisol levels. Each patient received replacement hydrocortisone after surgery and was reevaluated every 3 to 6 months with an adrenocorticotrophic hormone (ACTH) stimulation test. Each patient was also monitored carefully for symptoms and signs of adrenal insufficiency, which was defined as symptoms consistent with this diagnosis that responded to increases in hydrocortisone levels. After surgical resection, each patient was cured of hypercortisolism. Subsequently, despite replacement hydrocortisone, each patient had symptoms of hypocortisolism, and in four of eight patients the dose of hydrocortisone was increased to relieve the symptoms. Patients required a median time of 15 months (range, 9 to 22 months) to recover a normal ACTH stimulation test and 19 months (range, 12 to 24 months) to allow discontinuation of replacement doses of hydrocortisone. The results suggest that surgical resection of a cortisol-secreting adrenal tumor will result in rapid cure of hypercortisolism, but complete recovery of the HPA axis and discontinuation of replacement steroids will require between 1 and 2 years. Normal adrenal function, as assessed by the cortisol response to ACTH, returns despite replacement doses of hydrocortisone, and replacement doses of hydrocortisone can be tapered rapidly or discontinued after a normal ACTH stimulation test.

Adenoma↗
PubMed1990

Adjuvant 5-FU and MeCCNU improves survival following curative gastrectomy for adenocarcinoma.

During the 13-year period ending December 31, 1984, 51 patients treated by curative gastrectomy for gastric adenocarcinoma invasive beyond the submucosa were eligible to enter adjuvant chemotherapy trials. Twenty-one of 22 patients in the first treatment group (FMe) received 5-fluorouracil and a nitrosourea. The second group of eight patients received the same drugs plus Adriamycin (FAMe). Twenty-one patients were observed as surgical controls. Each adjuvant treatment group was subdivided into groups of patients with zero to four or five or more lymph node metastases for survival analysis. Fifteen patients were alive without evidence of disease at five years. Analysis of variance of survival times showed that lymph node status (P = 0.0001) and adjuvant chemotherapy (P = 0.01) were statistically significant prognostic variables. The FMe group had the best survival. A Fisher's exact test showed that the FMe group had a greater proportion of five-year survivors (P = 0.0217) than the no treatment arm. Patients with only zero to four positive lymph nodes in the FMe group had a statistically greater number of five-year survivors than patients in the no treatment arm (P = 0.0155). In this series, postoperative 5-fluorouracil and MeCCNU significantly improved the survival times of patients after curative gastrectomy for adenocarcinoma as compared with surgical controls.

Adenocarcinoma↗
PubMed1989

[Colorectal cancer: follow-up after curative resection].

From Jan 1978 to Dec 1984, 128 patients had a curative resection of colorectal carcinoma. A program for early detection and surgical correction of recurrences was initiated in 88 patients with a mean age of 61 years (range 24 to 85). Seventy two patients complied with the program involving clinical examination, chest X-ray, alkaline phosphatase and CEA determinations and endoscopy at 6 month intervals. Mean follow up was 36 months (range 6 to 60). A total of 28 recurrences (32%) were detected: 4 local, 17 distant and 7 local and distant. Recurrences occurred in 46% of grade C, 19% of grade B and 0% of grade A lesions. Sixty eight% of recurrences were detected within 12 months and 93% within 36 months after surgery. Recurrences were detected by clinical examination in 71% of cases. CEA determination was sensitive (81% and specific (92%) for detection of recurrences in the remaining patients. Four patients (14%) were reoperated on with a survival of 3 to 26 months, all dying from disseminated disease. We conclude that this program did not help to improve the 5 year survival rate of colorectal carcinoma submitted to curative resection. CEA determination may be indicated at 2 month intervals during the period of increased recurrence risk.

Adult↗
PubMed1989

[Randomized controlled study on adjuvant immunochemotherapy with PSK in curatively resected colorectal cancer. The Cooperative Study Group of Surgical Adjuvant Immunochemotherapy for Cancer of Colon and Rectum].

To evaluate of adjuvant immunochemotherapy with PSK in curatively resected colorectal cancer, randomized controlled study by 35 institutions in Kanagawa prefecture was conducted. From March 1985 till February 1987, 462 patients were assigned one of two different regimens. 448 patients (97.0%) of them satisfied the eligibility criteria. Control group received mitomycin C intravenously on the day and the day after the operations respectively followed by 5-FU orally over for 6 months. PSK group received in addition to mitomycin C and 5-FU as in control group, PSK orally for over 3 years. By February 1989, follow up studies of the patients after their operations had been carried out for two years to four years. The disease free curve and the survival curve of PSK group were higher than those of control group, differences between the two groups were statistically significant (Disease free curve: P = 0.0096, survival curve: p = 0.0391). From these results, adjuvant immunochemotherapy with PSK was considered beneficial for curatively resected colorectal cancer.

Adjuvants, Immunologic↗
PubMed1989

[Cooperative study of surgical adjuvant chemotherapy of colorectal carcinoma (second study): 3-year survival after surgery of non-curatively resected patients. Cooperative Study Group of Surgical Adjuvant Chemotherapy of Colorectal Cancer in Japan].

A prospective randomized study was carried out to evaluate the efficacy of surgical adjuvant chemotherapy for non-curatively resected colorectal carcinoma patients as a collaborative study at 428 institutes in Japan from Jan., 1984 to Dec., 1985. A total of 1,138 patients were entered in this study. All patients were divided according to disease location (colon or rectum) and received one of two chemotherapeutic regimens after surgery (Regimen C: MMC 12 mg/m2 i.v. at operation day and 6 mg/m2 in every 2 months +UFT 600 mg/day p.o., D: the same dose of MMC + UFT 400 mg/day p.o.) randomly. 556 cases (colon carcinoma regimen C: 148, D: 185 cases, rectal carcinoma regimen C: 94, D: 129 cases) were evaluable at this presentation. Three-year-survival rate of histologically confirmed non-curatively resected colon carcinoma patients was higher in the group receiving regimen C than in regimen D. But no significant difference was found among the other groups.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Effectiveness of cicletanine on lesions in spontaneously hypertensive rats. Curative study--dose-effect relationship].

Genetically hypertensive rats receiving a high sodium content diet develop, within weeks of their birth, major alterations of tissues and blood vessels. The purpose of this study was to evaluate the effects of cicletanine, a synthetic antihypertensive drug, on the progress of genetic hypertension. Iffa Credo SHR-SP male rats aged 11 weeks were divided into 4 groups. One group was used as control and 3 groups were treated with oral cicletanine in doses of 10, 30 and 90 mg/kg/day respectively. The control group showed a high mortality rate due to a significant decrease of weight gain and a highly significant increase of blood pressure, these changes being associated with lesions of tissues and vessels in the brain, heart and kidneys. A curative treatment with cicletanine improved these parameters and was accompanied by good tissue preservation. The curative effect of cicletanine seems to be due to an increase in endogenous prostaglandin synthesis.

Animals↗
PubMed1989

[Curative radiotherapy of unresectable bronchial cancer. Apropos of 266 cases without metastasis with 4 to 6 years follow-up (oat cell carcinoma excluded)].

Two hundred and sixty-six patients with inoperable bronchial carcinomas (oat cell excluded) without apparent metastases were treated with curative doses of radiotherapy. The malignancies were: 72% epidermoid epitheliomas, 11.5% adenocarcinomas, 10% large anaplastic cells and 6.5% without histology. According to the TNM classification, 3.5% were T1, 44% were T2 and 52% were T3. Mediastinal invasion was found in 44% of the cases. The mean age of the patients was 65 years (range 31-90 years). The Karnofsky index was less than or equal to 70 in 40% of the subjects. Unoperability was linked to the extent of local involvement in 59% of the cases and to age, general condition or an insufficient forced expiratory volume in 55% of the patients. Sixty to 65 Gy were administered, either classically fractionated or hypofractionated. After irradiation, 43% of the subjects underwent complete radiological remissions. Fifty-five percent of the patients died with local tumor evolution, 40% with isolated local evolution without associated metastases. The overall survival rate at 5 years was 7%; it was 16% for patients with a normal mediastinum and a Karnofsky index greater than 70 (51 cases); if these parameters were inversed, it was 2.5%. The fractionation protocol, the histological type, the use of chemotherapy (48 cases) did not affect the local control rate nor survival. There were almost no complications with this therapy. Patients frequently experienced functional improvement when curative doses of radiotherapy were applied to all the inoperable, non-metastatic cancers and the percentage of survivors at 5 years was non-negligible.

Actuarial Analysis↗
PubMed1989

[Curative surgery treatment of cancer of the biliary tract and exocrine pancreas].

Curative surgery for cancers of the biliary tract and pancreas varies according to their location. Cancer of the upper third of the extrahepatic bile duct is remarkable for the technical problems it raises, with the possible combination of partial or total liver resection followed by transplantation. Cancer of the lower third of this duct is similar to cancer of the pancreas as regards both diagnosis and treatment which consists of cephalic duodeno-pancreatic cancers. Cancer of the middle third should be treated, depending on its extension, as upper third or lower third cancer. The survival obtained by curative surgery is longer than that obtained by surgical or non-surgical palliative treatment, with an equal or higher operative risk, frequent cholangitis and an often mediocre quality of life.

Biliary Tract Neoplasms↗
PubMed1987

[Spontaneous course of metachronous metastases following curative intervention for colonic cancer: a total review].

The rate of metachronous metastases after curative surgery because of colonic carcinomas was 17% (n = 70). Women (20%) developed metastases more frequently than men (13%). Procedures in third to ninth decennium were followed in decreasing frequency (100 to 8.7%) by metachronous metastases. Primary tumors located in coecum showed by far the strongest tendency to recurrent metastatic disease (29%). Rate of metastases after curative surgery in tumorstage T 1-3 N0M0 was 9%, after stage T4 N0 M0 17% and after resection of tumors with lymph node involvement 32%. Liver metastases arose late when originating from primary in early tumorstage. Survival after diagnosis of liver metastases decreased with extension of primary tumor. These results give some aspects to formation of high-risk-groups to be followed-up according to a special program postoperatively.

Adult↗
PubMedDate not supplied

[Importance of a loco-regional follow-up after curative operation in cancer of the rectum or sigmoid].

After curative surgery for rectal or sigmoid cancer, loco-regional recurrence occurs in about 30% of the patients. Among them, one third presents no other tumor localization and a new curative surgical excision may, therefore be considered. A review of the literature shows that in these repeated procedures, the only good results, carcinologically, are observed when the original procedure consisted in a recto-colic anastomosis. Re-operations after abdomino-perineal resections have, until now, resulted in carcinologic failures. The location of the pelvic recurrence, after procedures which preserve the anal sphincter function, may be at the level of the anastomosis or most of the time around the anastomosis. If endoscopy is an easy mean of surveillance of the anastomosis, the screening of peri-anastomotic recurrences presents more of a problem. It seems necessary to use, in addition to rectal examination, other techniques which are more easily reproduced and compared with each other in the long run. This could be the case for endo-rectal sonography and pelvic tomodensitometry. As for re-operation itself, it consists essentially in an abdomino-perineal resection possibly associated with radiotherapy.

Follow-Up Studies↗
PubMed1987

Early adjuvant intraportal chemotherapy after curative hepatectomy for colorectal liver metastases--a pilot study.

A preliminary study was conducted with early and continuous intraportal adjuvant chemotherapy (IPAC) after a curative hepatectomy for colorectal metastases. The IPAC consisted of 14 days of 5-FU infusion at the rate of 600 mg/m2/d. The ultimate aim of this study was to reduce the frequency of recurrences in the remaining liver after curative hepatectomy. Twelve patients were included. IPAC was initiated in nine of them, while three technical failures occurred. The 14-day course with continuous 5-FU was given five times. The treatment had to be ceased prematurely because one medical and three mechanical complications occurred during the infusion. Pains and vomiting were frequent, but were usually the result of mechanical complications. No important hepatotoxicity or haematological toxicity was observed. This study shows that a full course of chemotherapy could be administered in only 40% of the patients. Further pilot studies with the aim of improving feasibility should be undertaken. If the mechanical problems are improved and IPAC duration is reduced, then feasibility should be dramatically increased. Subsequently, only a prospective randomized study would confirm the efficiency of the method in minimizing liver recurrence.

Adenocarcinoma↗
PubMed1986

Local recurrence in adenocarcinoma of the rectosigmoid colon after curative surgical resection.

Between January 1975 and January 1982, 157 patients with a diagnosis of adenocarcinoma of the rectosigmoid colon underwent curative surgical resection. The median follow-up was three years (range, 2.5 to 9 years). Two patients were excluded from the study for staging purposes because they received preoperative radiation. The remaining patients were categorized in the following stages: carcinoma in situ-3; A-14; B(1)-14; B(2)-41; B(3)-8; C(1)-1; C(2)-70; and C(3)-4. The overall local recurrence rate was 41 percent. The local recurrence according to stage was as follows: stage A-1/14 (7 percent); B(1)-2/14 (14 percent); B(2)-15/38 (39 percent); B(3)-3/8 (38 percent); C(1)-0/1; C(2)-31/56 (55 percent); and C(3)-4/4 (100 percent). Seventeen patients in stages B(2) and C(2) received postoperative irradiation. Only two patients (2/17, or 12 percent) recurred locally. In this study the local recurrence rate for patients undergoing curative surgical resection only was very high, especially in patients with advanced stage of disease (B(2) to C(3)). There is evidence that postoperative radiotherapy could minimize the local failure rate.

Adenocarcinoma↗
PubMed1986

A multifactorial approach for the prognosis of patients with carcinoma of the stomach after curative resection.

This study was done to define the prognostic role of some clinical and pathologic variables in patients with carcinoma of the stomach who underwent a curative subtotal gastrectomy for cancer located at the lower two-thirds of the stomach. An univariate and multivariate analysis, according to Cox's regression model, was retrospectively performed upon 361 patients operated upon at the Istituto Nazionale Tumori of Milan from 1965 to 1979 by a curative subtotal gastrectomy. Data were stored by an IBM 4331 computer. Several factors were taken into consideration: age, sex, site and size of tumor, gross appearance, histologic type, invasion of the gastric wall, nodal status and symptoms. Of six variables selected by the univariate analysis, only four (sex, age, lymph node status and degree of invasion in the gastric wall) were validated by the multivariate evaluation, whereas tumor size and symptoms lost their prognostic relevance. The most important variables were nodal status and the degree of invasion in the gastric wall. The influence of age had a different impact on survival time, depending upon nodal status. In fact, patients with positive nodes who were less than 60 years old had the worst prognosis; the same age group with negative nodes had the best prognosis. Multifactorial analysis, according to the automatic interaction detection procedure, showed that prognosis worsened progressively beginning with female patients with negative nodes at pT1 or pT2 (91.6 per cent five year survival rate), male patients with negative nodes at pT1 or pT2 (76.3 per cent five year survival rate), female patients with negative nodes at pT3 or pT4 (62.4 per cent), male patients with negative nodes at pT3 or pT4 (40.0 per cent), patients more than 60 years old with negative nodes (36.8 per cent) and patients less than 60 years old with positive nodes (20.8 per cent). In our opinion, these parameters should be taken into consideration when stratification of patients as candidates to undergo adjuvant treatment after surgical treatment is planned.

Adult↗