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At least 19 recordsLinked to original sources
PubMed1980

Percutaneous fine-needle aspiration biopsy. I. Its value to clinical practice.

From the experiences in dealing with 2591 cases of transthoracic and transabdominal fine-needle aspiration biopsies (1967-1978), we present our views on the value of this relatively new diagnostic method to clinical practice. Virtually any accessible localized lesion in any organ of the body can be investigated by fine-needle aspiration biopsy, which is considered most useful in patients with suspected malignant disease. Transthoracic and transabdominal fine-needle aspiration biopsy may provide information otherwise obtainable only by thoracotomy or laparotomy. It is an inexpensive and safe method with high accuracy for obtaining a pathologic diagnosis, and can impart some practical significance to clinical practice, especially in clinical management. The pitfalls in cytomorphologic interpretation, which often cause unsuccessful attempts, can be readily avoided with increased practical experience, as indicated by the increase in detection rate of lung cancer by fine-needle aspiration method from 82.8% in 1967-1968 to 93.4% in 1976 at the Toronto General Hospital. The accuracy of cytologic diagnosis plays a major role in spreading this still relatively unfamiliar but excellent diagnostic method. We believe that the method deserves widespread clinical application and when this happens, it will bring about great savings in health care resources.

Abdomen↗
PubMed1985

Specific active immunotherapy in patients with adenocarcinoma of the colon utilizing tumor-associated antigens (TAA). A phase I clinical trial.

Twenty-two patients received specific active immunotherapy (TAA vaccine once per month for 3 months), with the duration of follow-up, as of July 1984, ranging from 3 months to 36 months (median, 21 months). Of these, seven had Dukes B2, seven had Dukes C, and eight had Dukes D lesions. All received surgical resection, and those with Dukes D disease underwent resection of all metastases where possible, with six clinically disease-free at the time of initiation of therapy. The age range of the 22 patients was 40 to 73 years (median, 60 years); sex distribution was 12 males and 10 females. All patients were monitored by physical examination and by laboratory parameters including complete blood count, liver and renal function tests, blood chemistries, urinalysis, chest x-ray, carcinoembryonic antigen levels, migration inhibition assays, complete immune complexes, serum chemistries, helper and suppressor and total T-cell and B-cell assays, and TAA antibody levels. As measured by delayed cutaneous hypersensitivity skin test and by migration inhibition assays (MIA), a strong postimmunization response is developed approximately 5 months after vaccination is completed. There were no clinical or biochemical manifestations of any type of systemic toxicity including hepatic, renal, gastrointestinal, respiratory, or neurologic during the period of follow-up. All patients developed skin ulcers at the vaccination and required 4 to 5 months to heal. With this small number of patients in a Phase I trial, survival is indicative of the safety of the vaccine only: 82% of the patients are alive (mean survival, 21 months) thus far, and 59% of the patients are without evidence of disease (NED) (mean NED, 22 months). These studies, therefore, justify a Phase II-III trial in a larger number of patients and have provided selection of appropriate monitoring tests for the larger trial.

Adenocarcinoma↗
PubMed1990

Tumor cells in intraoperative pleural lavage. An indicator for the poor prognosis of bronchogenic carcinoma.

Fifty-nine patients with bronchogenic carcinoma and 21 patients with nonneoplastic lung diseases underwent intraoperative pleural lavage with 300-ml physiologic saline before (Lavage I) and after resection (Lavage II). The presence of tumor cells in the lavage fluid was established cytologically in 29 patients with bronchogenic carcinoma. Twenty-seven had positive findings in Lavage I and 23 of these also in Lavage II. Two patients had positive findings in Lavage II only. All controls were negative. In all 40% of patients with Stage I bronchogenic carcinoma had positive lavage results. The cumulative two-year survival rate of this group is 40%, which differs significantly (P less than 0.01) from the 97% survival rate of the patients with the same tumor stage whose lavage findings were negative. Detection of tumor cells in pleural cavity washings before resection proves that tumor cells have spread into the pleural cavity. Cytologic examination of an intraoperative pleural lavage should be done when assessing the tumor stage.

Adenocarcinoma↗
PubMed1991

Transurethral resection of the prostate and metastatic prostate cancer.

Demonstration of malignant cells in blood specimens collected during transurethral resection of the prostate (TURP) has implicated TURP in the dissemination of prostatic cancer. Of 153 patients who underwent radiation therapy for prostate cancer between January 1977 and June 1990 and were retrospectively analyzed, 93 were evaluable. Fifty-nine patients required TURP before radiation therapy for prostatic obstruction (BPH and/or cancer); the remaining 34 patients underwent radiation therapy after fine-needle aspiration biopsy. No statistically significant difference in failure rate could be detected between these groups, with a failure rate of 47% (28 of 59 patients) at a median follow-up time of 49 months (range, 8 to 146 months) in the TURP group versus a failure rate of 47% (16 of 34 patients) at a median follow-up time of 50 months (range, 3 to 122 months) in the group who underwent biopsy only (Fisher's exact test, P = 0.23). Within the confines of this retrospective study, it appeared that TURP did not enhance the development of metastatic disease.

Adenocarcinoma↗
PubMedDate not supplied

Incisional or excisional neck-node biopsy before definitive radiotherapy, alone or followed by neck dissection.

An analysis of 508 patients (660 heminecks) with head and neck squamous cell carcinoma and clinically positive neck nodes who were treated with radiotherapy alone to the primary lesion (with or without a neck dissection) was conducted to determine if open neck-node biopsy before definitive treatment adversely affected the probability of control of neck disease, the risk of distant metastasis, or the cause-specific survival rate. The prognostic factors analyzed included biopsy status of the neck, N stage, neck treatment, node mobility, node location, T stage, primary site, and control of disease above the clavicles. Sixty-six patients who had undergone an open neck-node biopsy before definitive radiotherapy were compared with a control group of 442 patients who did not undergo a neck-node biopsy; no detrimental effect of the biopsy on neck control, distant metastasis, or cause-specific survival was demonstrated. We conclude that the potential adverse effect of violating the neck before definitive treatment cannot be demonstrated if radiotherapy is the next step in the patient's management.

Biopsy↗
PubMed1980

Anesthesia and surgery: a double-edged sword for the cancer patient.

All therapeutic modalities used in cancer patients are associated with immunosuppression. Anesthesia and surgery represent a double-edged sword. By removal of gross tumor in many patients a restoration of general immune responses can be documented. In addition, circulating antigen or antigen-antibody complexes which block tumor-specific immune responses can be abrogated by removal of bulk tumor. However, animal data indicates that certain anesthetic agents and major surgical procedures may enhance growth of micrometastatic tumor foci. One mechanism by which this occurs might be immunosuppression. The use of immunorestorative drugs in the perioperative period has been able to reverse this phenomenon in animal tumor models.

Anesthesia↗
PubMed1982

Common-sense untoward factors in lung cancer resection.

Four common-sense untoward factors (age over 60, pneumonectomy, microresidual disease, and postoperative empyema) were retrospectively evaluated in a consecutive series of 199 surgically apparently complete non-oat cell lung cancer resections. By single-factor analysis all factors showed a lower survival that was contingent for microresidual disease and age over 60. For stage I tumors the negative impact on survival was significant for all except empyema, and for stage II and III tumors only for empyema. Without confounding factors, microresidual disease and age over 60 were negative prognostic factors only for distant mortality, empyema a negative prognostic factor only for early mortality, and pneumonectomy a probable negative prognostic factor for both early and distinct mortality. It is concluded that the scientific method used confirmed the prognostic assessment of common sense for these four factors.

Age Factors↗
PubMed1987

Autotransplantation of colonic tumors into the colonic wall of the rat.

Colonic tumors were induced in Sprague-Dawley rats by weekly subcutaneous injections of 1,2 Dimethylhydrazine (DMH) for 4 months. The animals were thereafter laparotomized and a palpable tumor was transplanted into the same animal in a tumor-free area of the transverse colon. Autotransplanted tumors were considered those tumors growing in the wall of the transverse colon, covered by intact colonic mucosa. The frequency of autotransplanted tumors was 34%. The possibility that autotransplantation may also occur in humans by accident, during procedures to remove a colorectal adenocarcinoma, is discussed.

1,2-Dimethylhydrazine↗
PubMed1992

Extraneural metastases in ependymoma.

Ependymomas, glial neoplasms usually arising in the posterior fossa or spinal cord, rarely metastasize outside the central nervous system. We have reviewed all 81 ependymomas evaluated at MSKCC between 1956-1989. Five (6.2%) had extraneural metastases (ENM). The primary tumor was in spinal cord in 3 patients and the cerebral hemisphere in 2. Two tumors were histologically anaplastic; 3 were histologically benign. The 5 patients were 3, 3, 3.5, 16 and 37 years old. Time from initial diagnosis to development of ENM was 0, 15, 35, 40, and 288 months. At the time of ENM the primary tumor was progressing in 4/5 patients. Prior therapy had included resection plus radiation therapy (RT) (1), RT plus chemotherapy (1), resection plus RT plus chemotherapy (2). One patient had not received prior therapy because ENM were present at diagnosis. The sites of ENM included lung and thoracic lymph nodes (2), pleura and peritoneum (2), and liver (1). Both patients with peritoneal ENM had had ventriculoperitoneal shunts. ENM did not correlate with histologic grade, age, or degree of surgical resection. When patients with ependymoma develop signs or symptoms of systemic disease such as abdominal pain, cough, or adenopathy, ENM should be considered.

Adolescent↗
PubMedDate not supplied

The influence of intramedullary nailing upon the development of metastases in the treatment of an impending pathological fracture: an experimental study.

An experimental model has been developed in which the effects of a pathological fracture and intramedullary nailing on metastatic spread have been investigated. The endpoint used was the production of lung metastases in rats inoculated intracortically with a rhabdomyosarcoma. We have found that a pathological fracture markedly increases the incidence of lung metastases and that intramedullary nailing, by decreasing the incidence of fractures, decreases the incidence of lung metastases. The surgical procedure itself does not increase the incidence significantly. It is concluded that in metastatic disease prophylactic nailing of an impending pathological fracture is the treatment of choice.

Animals↗