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At least 163 records · Page 9Linked to original sources
PubMed1986

Medulloblastoma in childhood: results of radical resection and low-dose neuraxis radiation therapy.

This review concerns 22 children who were treated from 1980 through 1983 for medulloblastoma in the posterior fossa. Treatment included attempts at radical resection of the tumor and postoperative craniospinal radiation therapy, with 5000 to 5500 rads directed to the posterior fossa and 2500 rads to the remaining craniospinal axis. This lower radiation dose to the neuraxis was used to avoid late adverse effects upon the growing central nervous system of the children. Gross confirmation of total resection was obtained in 13 patients (the "total resection group"); however, nine patients had a subtotal resection leaving a small portion of the tumor extending into the cerebellar peduncles or the cerebellopontine angle, or else encasing the posterior inferior cerebellar artery (the "subtotal resection group"). Six patients in the total resection group demonstrated tumor extension into the cerebellar peduncles, which was removed by means of a surgical carbon dioxide laser without neurological sequelae. Biopsy of the arachnoid membrane from the cisterna magna and cytological examination of the cerebrospinal fluid (CSF) prior to manipulation of the tumor were carried out in 12 patients. All but one showed dissemination of medulloblastoma cells. Myelography and CSF cytological study were undertaken 2 months after radiation therapy in 12 patients and were positive in two. There were no case mortalities in the total resection group during the 24- to 67-month follow-up period, whereas the 1-year survival rate in the "subtotal resection group" was only 44.4%. This study suggests that medulloblastoma can be controlled with a low radiation dose to the neuraxis, should a grossly confirmed total resection be achieved at craniotomy.

Adolescent↗
PubMed1992

[Recurrent hepatocellular carcinoma after hepatic resection].

A total of 125 patients with hepatocellular carcinoma (HCC) treated by hepatic resection in our department from 1970 to 1989 were reviewed to determine recurrent factors, recurrent modes of HCC and to assess the treatment for recurrent HCC. Seventy-five of 125 patients had recurrent tumors after the first hepatic resection. The 1-, 2-, and 3-year cumulative recurrent rates after hepatic resection were 25%, 52% and 67% respectively. The size of the tumor, intrahepatic metastasis, portal vein involvement, clinical stage and DNA ploidy pattern were judged as useful predictive factors for recurrence of HCC after hepatic resection. In the patients with intrahepatic metastases, the bilateral lobes of the remnant liver were the most frequent recurrent sites. The treatment for recurrent HCC was divided into 3 groups such as re-resection, transcatheter arterial embolization (TAE) and palliative treatment. The survival curves of patients receiving re-resection and TAE were significant better than those of patients receiving palliative treatment. Patients treated by re-resection for recurrent HCC had the longest survival. The 1-, 3- and 5-year cumulative survival rates after re-resection were 84%, 60% and 48% respectively. It is concluded that the early detection of recurrent HCC is important and re-resection or TAE is effective treatment for recurrent HCC.

Adult↗
PubMed1992

[Role of resection of the celiac plexus in the analgesic treatment of pancreatic cancers].

The aim of this study was to evaluate the pain relief related to resection of the celiac plexus in pancreatic carcinoma. This technique was attempted in 26 consecutive patients and performed in 23 (feasibility: 88%), whose mean age was 64 years. Before surgery, patients were divided into two groups: patients not treated by narcotic analgesics (group 1, n = 10) and patients treated by narcotic analgesics (group II, n = 13). Surgery was indicated in 22 patients for pancreatic resection or by-pass, and in 1 patient for pain relief after an unsuccessful per-cutaneous celiac plexus block. Resection of the celiac plexus was always performed via a trans-peritoneal approach, after mobilization of the head of the pancreas and the duodenum. Only the right half of the celiac plexus was resected in 4 patients (17%) due to technical difficulties. Pathologic examination was performed in 16 patients (8 patients from each group) and neoplastic involvement was observed only in 3 patients of group II. There was no operative death. Two complications related to this method occurred (9%). One patient developed a chylous ascites and was treated conservatively. In a second patient, an occlusion of the celiac trunk was complicated by infarction of the spleen and of the left lobe of the liver; this patient was reoperated and his subsequent post-operative course was uneventful. In group I, eight patients (80%) did not require narcotic analgesics after resection of the celiac plexus. Two failures occurred, one immediately after surgery and one delayed. In group II, seven patients (53%) did not require narcotic analgesics; 6 of these 7 patients died. Six failures occurred, 4 early after surgery and 2 delayed. Three of the 4 early failures occurred in patients who underwent resection of the right half of the celiac plexus. The authors concluded that resection of the celiac plexus seems to be an effective pain treatment in pancreatic carcinoma. However, resection must be bilateral to provide analgesia. Specific morbidity of this technique may lead to the use of non-surgical methods if surgery is not indicated for pancreatic resection or by-pass.

Adenocarcinoma↗
PubMed1979

[Experimental and clinical studies on blood coagulation and lysis system after hepatic resection (author's transl)].

Blood coagulation and lysis system was studied with other biochemical serum analysis in three groups of mongrel dogs; laparotomy without hepatic resection (group I), with 50% hepatic section (group II), and 70% hepatic resection (group III). In clinical studies, six cases of hepatic tumors and one case of hepatoma with cirrhosis were selected for examinations. All the data examined in group I were restored toward normal within 48 hours. Total serum protein level was significantly decreased after hepatic resection. The protein level in group III was lower than in group II on the 4th postoperative day (P less than 0.01). In clinical studies, low serum protein levels did not reach a preoperative value even 3 weeks after extended right hepatic lobectomy. Time course of Al-P and transaminase changes in clinical studies was similar to that in experimental study with dogs. Al-P and transaminase showed an abnormally high level in the patient with hepatic cirrhosis. Serum bilirubin levels were not increased after hepatic resection. In blood coagulation and lysis system, serum fibrinogen levels were markedly decreased: 50% reduction in group III and 30% reduction in group II on the first postoperative day. The degree of decrease in the fibrinogen level was proportional to the size of resected volume of the liver. On the other hand, in clinical studies fibrinogen levels were slightly decreased. In the case of hepatic resection with cirrhosis, however, the values were markedly decreased: 40% reduction on the 4th and 25% on the 21st postoperative days. Fibrinolysis system was accelerated group II and III. The acceleration continued until 3 weeks after hepatic resection. From these results it may be concluded that analysis of blood coagulation and lysis system after hepatic resection is useful in evaluating a residual hepatic function after partial resection and in selecting a treatment suitable for hepatic insufficiency.

Adolescent↗
PubMed1989

Stereotactic biopsy and resection of thalamic astrocytomas.

In this study of 72 patients who had histologically verified thalamic astrocytomas, 44 patients underwent stereotactic serial biopsy, 22 underwent stereotactic resection of the neoplasm, and an additional 6 patients underwent stereotactic biopsy followed by stereotactic resection of the tumor at a later date. Of the 50 patients who underwent stereotactic biopsy, 3 were neurologically worse after the procedure (morbidity, 6%), and 3 additional patients with Grade 4 astrocytomas who preoperatively were rapidly deteriorating neurologically, died within 30 days of the procedure. Of the 28 patients who underwent stereotactic resection, 14 were neurologically improved after the procedure, 10 were unchanged, and 4 were worse. One additional patient died 10 days postoperatively. Thirty-four patients had Grade 4 astrocytomas: 27 underwent stereotactic biopsies. The mean survival after biopsy and irradiation for patients with Grade 4 astrocytomas was 21.4 weeks. The mean survival was 62 weeks in 7 patients with Grade 4 astrocytomas who underwent stereotactic resection and radiation therapy. The mean survival time after biopsy and radiation therapy for patients who had Grade 3 and Grade 2 lesions was 54.4 weeks and 91 weeks, respectively. Twenty-three patients had pilocytic astrocytomas; 8 underwent stereotactic biopsies, and 19 underwent stereotactic resection of the tumor (4 of these underwent biopsy prior to resection). There was no neurological morbidity, but one patient died after resection. Many of those who underwent resection were deteriorating due to an enlarging tumor mass or recurring cyst, and had undergone more conservative therapies such as biopsy and radiation. Even though stereotactic biopsy is appropriate in many patients harboring thalamic astrocytomas, selected patients with significant mass effect from solid tumor or recurring cyst can benefit from stereotactic resection.

Adolescent↗
PubMedDate not supplied

[Regeneration ability of ischemic liver and the effect of liver resection and extracts stimulating proliferation].

DNA synthesis was studied in liver nuclei of Wistar rats after 30% liver tissue resection, 2 hr ischemia of 70% liver tissue or 2 hr ischemia of 70% liver tissue with resection of intact lobes. DNA synthesis was markedly increased in ischemic lobes and was especially high in ischemic lobes if simultaneous resection of intact lobes occurred; maximum of the synthesis was observed within 32 hrs after the operation. Proliferation stimulating extracts, isolated from liver tissue within 48 hrs after the resection or after ischemia, intensified the regenerating processes in the resected liver tissue; the first preparation (from resected liver tissue) exhibited the most distinct effect as compared with the second extract (from ischemic liver tissue). Proliferation stimulating extracts did not affect the cytochrome P-450, content of which was decreased after resection and ischemia. The data obtained suggest the important role of proliferation stimulating factors in regeneration of liver tissue after ischemia or resection; these factors proved to be possible to isolate from ischemized and reperfused liver tissue; the medicinal effect of resection was shown.

Animals↗
PubMed1988

A prospective study of perioperative and postoperative control of acid hypersecretion in patients with Zollinger-Ellison syndrome undergoing gastrinoma resection.

Fifty-five consecutive patients with Zollinger-Ellison syndrome who underwent exploratory laparotomies for gastrinoma resection were evaluated prospectively to determine the effect of gastrinoma resection on acid secretion and to establish criteria for safe and effective perioperative management of gastric acid hypersecretion. In 15 patients (27%) no tumor was found and postoperative serum gastrin, basal acid output (BAO), and maximal acid output (MAO) were unchanged. Twenty-one patients (38%) had gastrinomas resected and were biochemically cured. Median fasting gastrin, median delta secretin, mean BAO, and mean MAO decreased 89%, 94%, 80%, and 43%, respectively, at 3-month follow-up in these patients. In 19 patients gastrinomas were resected, but patients were not cured, and median fasting gastrin, median delta secretin, mean BAO, and mean MAO decreased 47%, 10%, 26%, and 25%, respectively. Forty percent of patients with gastrinoma resected and cured and 81% of patients with gastrinoma resected but not cured continued to hypersecrete acid (BAO greater than 10 mEq/hr) at 3- to 6-month follow-up. Acid control was managed perioperatively during gastrinoma resection by continuous intravenous infusion of H2 receptor antagonists at a dose established by preoperative titration to decrease acid output to less than 10 mEq/hr. Thirty patients were treated with cimetidine at a mean dose of 3.2 mg/kg/hr for a mean of 13.8 days. Twenty-one patients were treated with ranitidine at a mean dose of 1.1 mg/kg/hr for a mean of 8 days. No patients suffered any complications related to acid hypersecretion or side effects of the H2 antagonists. Patients undergoing gastrinoma resection can be managed safely by continuous infusion of H2 antagonists. Successful gastrinoma resection can reduce acid output, but even 40% of biochemically cured patients will continue to hypersecrete acid at short-term follow-up and will require continuation of antisecretory medication.

Adult↗
PubMed1986

Abdominosacral resection of the rectum.

Abdominosacral resection is the most reliable radical sphincter saving operation for midrectal cancers which are too low for anterior resection. The posterior incision provides maximum exposure for wide resection of the tumor, a measured distal margin, and an accurate anastomosis. The procedure can be carried out consistently to the pelvic floor without disrupting the anal sphincters and their innervation. Sphincter function is consistently preserved. The risk of abdominosacral resection is comparable to that incurred for anterior resection or abdominoperineal resection. Mortality rate is 2%. Morbidity can be limited by the selective use of a protective colostomy. The use of abdominosacral resection has extended sphincter saving resection to include 77% of 646 consecutive patients with rectal cancer. Abdominosacral resection provides the maximum clearance around the tumor and long term follow up has revealed no greater risk of local recurrence or death from cancer.

Abdominal Muscles↗
PubMed1988

[Reconstruction of the pelvic ring based on classification following resection of bone tumors].

Bone tumors in the pelvis (28 cases), which had been treated surgically were classified into types I to V and their subtypes A and B, according to the location and range of tumor resection, and were assessed with regard to both the method of reconstruction used and restoration of function. Type I-A, -B (6 cases) did not require any reconstruction of the pelvic ring. However, with type I -B, some difficulty was experienced in maintaining balance upon sitting for a long period. Type II (3 cases) included cases of resection of the anterior part of the pelvis, resulting in loss of ring continuity, but reconstruction was not necessary. In type III -A, the acetabulum excluding the hip joint (1 case) was resected and arthrodesis of the ilium and the femoral head performed. In type III -B the acetabulum with the hip joint was resected (2 cases) followed by replacement of the pelvis and hip joint with an artificial prosthesis. Type N included cases (5) of partial (-A) or total (-B) sacroiliac resection, both of which needed massive bone grafting to reconstruct the pelvic ring. Type V (7 cases) required partial (A) or total (B), resection of the sacrum dynamic reconstruction by spinal instrumentation and massive bone grafting. Among 13 cases of primary malignant bone tumors for which tumor resection was performed, 3 cases recurred. This classification was useful for comparing the surgical modalities of tumor resection, reconstruction and their functional results. Our method of total sacral resection was also introduced.

Adolescent↗
PubMed1987

The role of resection in the treatment of pulmonary metastases from Ewing's sarcoma.

We have investigated the role of resection in the treatment of patients with isolated pulmonary metastases from Ewing's sarcoma. In a retrospective review, 19 patients with the diagnosis of Ewing's sarcoma treated at the National Cancer Institute from 1965 to 1985 who underwent chest exploration for resection of pulmonary nodules were evaluated. Ten patients (53%) were made disease free by resection of pulmonary metastases, six patients (32%) were found to have unresectable disease, and three patients (16%) were found to have benign pulmonary disease. The actuarial 5 year survival rate of the 10 patients successfully made disease free by resection was 15%, and the median survival of this group was 28 months. In contrast, the median survival of the six patients not made disease free was 12 months, and no patient with residual disease was alive 22 months after thoracotomy (p2 = 0.0047). There were no postoperative deaths and only three minor postoperative complications for 25 operative procedures. Various prognostic variables were analyzed to determine their influence on postmetastasectomy survival. There was no difference in postmetastasectomy survival between patients who underwent resection of synchronous versus metachronous pulmonary metastases (p2 = 0.90). Patients who underwent resection of fewer than four malignant nodules had a significantly longer postmetastasectomy disease-free survival (p2 = 0.0019) and overall survival (p2 = 0.06) than those undergoing resection of four or more nodules. Patients who underwent resection of metastases that developed during chemotherapy had a significantly shorter postmetastasectomy survival that those who underwent resection of metastases that developed after chemotherapy (p2 = 0.0295). Our data show that selected patients with Ewing's sarcoma metastatic to the lungs may benefit from an aggressive surgical approach. Also, a significant proportion of these patients will have benign pulmonary disease and can thus avoid additional intensive systemic therapy.

Adolescent↗
PubMed1978

Colonic interposition between the jejunum and ileum after massive small bowel resection in rats.

Most patients who undergo massive small bowel resection develop the "short bowel syndrome", which usually resolves as intestinal adaptation takes place. Some, in whom adaptation appears to be inadequate, remain severely incapacitated, and attempts have been made to improve absorption using a variety of surgical maneuvers. Successes have been recorded, but the procedures (of which reversal of a segment of small intestine to prolong the intestinal transit time has been most frequently used) are unpredictable and may actually be harmful. This study was designed to evaluate the theory that, because of the slow pattern of peristaltic activity inherent in the colon, the intestinal transit time could be safely and predictably prolonged after massive small bowel resection by transposing a segment of colon to between the jejunal and ileal remnants in an iso-peristaltic direction. The following procedures were performed, using 56 rats: (1) Resection of 80% or 90% of the small intestine. (2) Small bowel resection (80% or 90%) and iso-peristaltic jejuno-ileal colonic interposition. (3) Bowel anastomoses without resection. Intestinal function was subsequently evaluated by studying the following: (1) body weight; (2) blood count; (3) intestinal transit time (by contrast radiography); (4) intestinal absorption of sodium iodide, albumin, triolein and Vitamin B12 (using radioisotopic methods); (5) intestinal morphology. Colonic interposition did not have any significant effect following 80% small bowel resection. After 90% resection, colonic interposition increased the intestinal transit time significantly (p less than 0.001) without mortality or serious morbidity, and did not cause intestinal obstruction or prevent intestinal adaptation. Body weight and intestinal absorption were not increased significantly, but the study was too short to exclude an eventual beneficial effect in terms of body weight. It was concluded that iso-peristaltic colonic interposition is a safe and reliable method of prolonging the intestinal transit time after massive small bowel resection in the rat, thereby increasing the efficiency of absorption within the existing absorption capacity. The procedure has been found to be beneficial in dogs, and for reasons discussed, should be equally effective in man. Adjunctive surgery is not recommended at the time of resection in man, but should be considered if absorption remains severely impaired.

Animals↗
PubMed1977

[Liver damage after resection of the stomach: evaluation of 215 cases (author's transl)].

Only 11% out of 215 patients with resection of the stomach had a normal liver if the term of the resection was not longer ago than 30 years. Contrarily the deposition of fat became less frequent with increasing distance from the operation term while deposition of iron (siderin) was demonstrable nearly equaly in all groups. Age and sex did not influence the behaviour of the liver after resection of the stomach. The information value by blood transaminase activity (GOT/GPT) decreases with the distance of time from the resection term. Alcoholics (n = 20) had less shares of post resection liver harms than non-alcoholics. Thus alcohol seems to be not a bigger risk for resectioned as for people with normal stomach. Repeated liver biopsies after different intervals of time pointed out that a change for the worse happened more often with increasing distance to the resection term. Therefore resected patients should be examined regularly, including liver biopsy, as to discover in time a growing up liver damage. After resection of the stomach discovered liver diseases refer to a damage caused by that stomach disease which induced the operation.

Adult↗
PubMed2026

Endoscopic submucosal dissection for locally recurrent gastric neoplasia following endoscopic resection: a systematic review and meta-analysis.

BACKGROUND AND AIMS: Endoscopic submucosal dissection (ESD) for locally recurrent gastric neoplasia following endoscopic resection (ER) is technically challenging because of scar-related submucosal fibrosis. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of salvage ESD in this setting. METHODS: Multiple databases were searched through December 2025 for studies reporting ESD outcomes for locally recurrent gastric lesions at or contiguous with a prior ER scar. Primary outcome was curative resection and need for surgery. Secondary outcomes were en bloc and R0 resection, local recurrence, delayed bleeding, and perforation. Meta-analyses were performed using a random effects model. Heterogeneity was assessed using I2. RESULTS: Seven studies (259 patients; 265 ESDs) were included. Across 5 studies and 243 ESDs, pooled curative resection rate was 69.7% (95% CI, 60.6-78.1; I2 = 38%), while 8.2% (95% CI, 3.3-14.6; I2 = 38.4%) required surgery. En bloc resection rate was 92.3% (95% CI, 79.1-99.7; I2 = 83.7%) across 6 studies, and pooled R0 resection rate was 87.5% (95% CI, 82.1-92.2; I2 = 0%) across 4 studies. Over a mean follow-up of 42 months, pooled local recurrence was 2.0% (95% CI, 0.0-9.7; I2 = 54.1%) across 6 studies. Delayed bleeding was 4.1% (95% CI, 0.8-9.0; I2 = 40.8%) and perforation was 4.1% (95% CI, 1.6-7.3; I2 = 0%). CONCLUSIONS: ESD for locally recurrent gastric neoplasia after ER achieves acceptable curative resection, high en bloc/R0 resection, and low local recurrence and morbidity. It is a viable organ-preserving option for appropriately selected patients, ideally performed at expert centers with close surveillance.

Humans↗
PubMed1986

Resection of recurrent pulmonary metastases in patients with soft-tissue sarcomas.

Survival benefit and prognostic factors useful for patient selection have not been previously analyzed for patients with recurrent pulmonary metastases from soft-tissue sarcomas. Twenty-nine patients in our study had two or more resections of pulmonary metastases from 1976 to 1983. There were no operative deaths and three complications for 40 operations (7.5%). Factors predictive of increased survival following the second resection of pulmonary metastases were resectability and a disease-free interval of greater than six months from the first thoracotomy to the second recurrence in the lung. The tumor doubling time of the first recurrence and the presence of three or fewer nodules on full-lung tomography before the first thoracotomy, which were predictors of survival following initial resection, also predicted survival following subsequent resections. Overall median survival following the second resection was 14.5 months (22% overall three-year survival). The postresection actuarial survival curves for patients undergoing 1, 2, or 3 or more resections were not significantly different. Our findings demonstrate that patients undergoing repeated resections of pulmonary metastases from soft-tissue sarcomas can achieve prolonged survival.

Actuarial Analysis↗
PubMed1990

The effect of intestinal resection and urogastrone on intestinal regeneration.

Intestinal regeneration in patched intestinal defects is enhanced by both intestinal resection and urogastrone. Our aim was to determine if these two stimuli have synergistic effects. Ileal defects were patched with colon serosa in 45 rabbits. Group 1 (n = 11) were control subjects; group 2 (n = 12) underwent 50% intestinal resection; group 3 (n = 11) received urogastrone (1.5 micrograms/kg per hour subcutaneously); and group 4 (n = 11) underwent intestinal resection and received urogastrone. Animals were killed at 7 and 14 days. Intestinal resection had the greater effect on epithelialization. Urogastrone inhibited contraction and intestinal resection did not. Both intestinal resection and urogastrone increased proliferative activity. Combining intestinal resection and urogastrone did not have a synergistic effect on epithelialization and diminished the effect of urogastrone on proliferation and contraction. These findings suggest that intestinal resection and urogastrone stimulate epithelialization via similar mechanisms and that urogastrone would not enhance regeneration during intestinal adaptation.

Animals↗
PubMed1992

Elective hepatic resection in the elderly.

This retrospective review assessed the safety and validity of elective liver resection in patients older than 64 years of age. In all, 293 patients underwent elective liver resection over a 23-year period (1967-1990). Fifty-two patients (18 per cent) were older than 64 (maximum 84, mean 70.4) years and all but four of these did not have cirrhosis. In this older subgroup, indications for resection were liver metastases in 30 patients, primary malignancy in 16, benign tumours in five and multiple abscesses in one. There were 21 major resections, with two deaths from hepatic failure, and 31 minor resections, with one death from cardiac failure (total mortality rate 6 per cent). During the same period, there were seven deaths after elective resections performed in 222 patients without cirrhosis who were younger than 64 years (P = 0.39). Mortality rate and duration of postoperative hospital stay were not related to the extent of liver resection nor to patients' grading according to the American Society of Anesthesiologists' criteria. Intraoperative blood loss was the only parameter found to influence mortality rate (P = 0.008) and duration of hospital stay (P = 0.04). Elective liver resection can be safely undertaken in elderly patients without cirrhosis, provided that intraoperative blood loss is minimized.

Age Factors↗
PubMed1991

Simultaneous resection of colorectal carcinoma and synchronous liver metastases in a district hospital.

Of 491 patients operated for carcinomas of the colon or rectum between 1984 and 1989, 106 were tumour stage IV, U.I.C.C.(Dukes' 'D') at time of operation. In 22 of these cases a radical resection of the carcinoma of the colon or rectum and of synchronous liver metastases was performed simultaneously. In 20 patients the metastases were confined to one, in two they were found in both hepatic lobes. In one case a solitary metastasis of the lower lobe of the right lung was resected additionally. Three right-sided hemihepatectomies, one extended right hemihepatectomy, five left-sided hemihepatectomies, three left-sided lateral segmentectomies, seven atypical segmental resections and three wedge resections were performed. The mean operation time for the radical resection of the carcinomas of the colon or rectum as well as of the liver metastases was 3.5 (3-5.2)hours. An average of 3 (0-9) blood units were needed intraoperatively. The major liver resections were performed in complete normothermic vascular ischaemia using the finger fracture method. The time of ischaemia ranged between 8 and 25 min. Only 1 of 22 patients died postoperatively (30 days postoperative hospital mortality rate 4.5%). Five of 17 patients were free of tumour 2 years after operation. Eight of 22 were alive 2 years after operation (non-age corrected 2-year survival rate 36.4%), 2 of them are alive more than 5 years after treatment. Our results demonstrate that simultaneous resection of colon or rectum carcinoma and of synchronous (resectable) liver metastases can be performed successfully, even in a district hospital.

Austria↗
PubMed1991

Extended resection in the treatment of colorectal cancer.

Between 1975 and 1990, 525 patients underwent resection of colorectal cancer in our unit. Of these, 38 had tumour invading adjacent structures and underwent an extended resection. Overall, there were 67 cases treated palliatively. Of these, three were in the group of 38 having an extended resection. When the groups of radical not extended (n = 423) and radical extended resections (n = 35) were compared, respective values for mortality (1.9% vs 0) and morbidity (12.8% vs 11.3%) were not different. Respective local recurrence rates (13% vs 26%) were significantly greater after extended resection. Five-year survival after extended resection was 30%, no different from the general survival rate for standard resections for T2-3 node-positive tumours. Extended resection is thus a safe and important approach for locally advanced tumours.

Adult↗