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At least 19 recordsLinked to original sources

[The value of radiotherapy in the treatment of lip neoplasms].

About 80% of carcinomatous lesions of the lip are smaller than 2 cm in diameter, have little tendency to infiltrate, grow in the lower lip, are histologically well differentiated and do not have, or develop later, regional metastases. Of these carcinomas 95% are cured by the various methods of radiotherapy. The criteria for a more serious prognosis, such as expansive growth, deeper infiltration, location on the upper lip and/or the commissures, undifferentiated grading and regional lymphatic metastases, are found only in a minority of patients with carcinoma of the lip. However, even for tumors of the T3 category rates of cure of over 90% are reported, as confirmed by our own results with supervoltage irradiation with fast electrons of the betatron during the years 1961-1970. The techniques and indications of interstitial Curietherapy with iridium-192 wires are described. The treatment of primary lymphnode metastases, which should be confirmed histologically or cytologically before therapy, is described in detail. Neck dissection is superior to irradiation therapy. General elective neck dissection, as normally performed for carcinoma of the oral cavity, is not justified because of the low rate of metastases and the results of elective therapy. A case report demonstrates the poor prognosis in patients with regional fixed metastases.

Hair Removal

[Results of therapy of lip neoplasms from a radiotherapeutic point of view].

The increasing use, in recent years, of surgical methods for the treatment of labial carcinomata caused us to review the results of treatment by means of irradiation. The different methods of radiotherapy are described, and a comparison is made between the results of radiotherapy and surgical treatment. Also, cases are described in which it is indicated to use either surgical treatment or radiotherapy or a combination of the two methods.

Adult

Malignant salivary gland neoplasms of the lip.

The charts of fourteen patients with malignant salivary gland tumors of the lip were reviewed. These patients represented 1 per cent of all patients seen during this same period of time with malignant salivary gland tumors. No specific etiologic factors were implicated except that the tumors occurred predominantly in white males. The overall results of treatment were poor, perhaps secondary to delay in diagnosis, very biologically aggressive tumors, or inadequate or improper treatment. Hopefully, the 20 per cent survival can be improved with planned combined sequential surgery and radiation in those selected high risk patients.

Adenocarcinoma

Renal metastases simulating Kaposi sarcoma. Radionuclide scanning, an aid in diagnosis and treatment planning.

A case of renal cutaneous metastases simulated Kaposi sarcoma and the condition was misdiagnosed as Kaposi sarcoma. A new technique was employed using the isotope technetium 99m as the compound sodium pertechnetate Tc 99m for the diagnosis and evaluation of the extent of Kaposi sarcoma. The failure to demonstrate a positive isotope scan in our case was a clue to the incorrect diagnosis of Kaposi sarcoma.

Aged

The place of irradiation in the management of the primary lesion in head and neck cancers.

Lesions of the skin are best excised except for specific locations where surgical excision would not likely produce disease-free margins and/or would require extensive plastic repair. A control rate of 90% for T1 lesions and 80% for T2 lesions is obtained with irradiation in the squamous cell carcinomas of the upper respiratory and digestive tract. Heavy smokers and/or severe alcoholics may be preferably treated surgically. The control rates in the T3 and T4 lesions are unsatisfactory with either irradiation or surgery alone. Pre- or postoperative irradiation combined with the appropriate surgical procedure improves the local control rates and to some extent the survival rates. Postoperative irradiation for the highly malignant tumors of the salivary gland reduces the local failure rate from 36% to 11%. The facial nerve can be preserved unless it is grossly involved.

Carcinoma, Squamous Cell

Cervical-pectoral flaps in the treatment of advanced oral cancer.

Twenty-two of 90 patients with carcinoma of the anterior oral cavity treated at the Minneapolis Veterans Administration Hospital from 1965 through 1973 had advanced lesions - tumors attached to the mandible and/or more than 3 cm in size. These patients were treated by primary radical neck dissection, en bloc excision, and segmental mandibulectomy. A cervical-pectoral flap combination was used for reconstruction. The functional and cosmetic results were excellent. Patient survival and cure rate compare favorably with other series. We emphasize the need for wide initial resection with immediate reconstruction.

Adult

Head and neck cancer manpower study.

1. Approximately 40,000 cases of cancer of the head and neck (excluding skin) are diagnosed each year. 2. Approximately 20,000 of these cases and 30,000 cases of skin cancer are treated by 366 head and neck cancer surgeons. 3. Ninety per cent of the cases are treated by 63 per cent of the surgeons. 4. Fifty-eight per cent of the surgeons care for between 50 and 300 cases per year. 5. While 2,759 new board-certified surgeons of all specialties are recruited annually to maintain a work force of 46,000 board-certified surgeons (3), apparently 730 potential head and neck cancer surgeons are being prepared to maintain a work force of approximately 450 head and neck cancer surgeons. 6. These findings indicate the need for in-depth study of the manpower needs in head and neck cancer surgery by all who are responsible for the training of surgeons in this field.

General Surgery