Cancer

This essay is the second in a series of essays by cancer patients. Perceptions of two individuals, a patient and a doctor, are detailed in the present article. Readers are encouraged to share their thoughts about these essays in correspondence.

This essay is the second in a series of essays by cancer patients. Perceptions of two individuals, a patient and a doctor, are detailed in the present article. Readers are encouraged to share their thoughts about these essays in correspondence.

Sentinel lymph node surgery is increasingly used in the management of cutaneous malignancies. This commentary indicates the surgical, pathologic, and nuclear medicine techniques necessary for success.

The 5-year survival rates for patients in the corresponding stages of the Chinese 1992 and fifth-edition International Union Against Cancer (UICC) systems are almost identical in spite of differences in criteria defining the T and N classifications. However, the authors of this study believe that the UICC system is slightly better.

The results of this study indicate that mucosal carcinomas with ductal involvement (DI) that extends to the submucosa should not be classified as submucosal carcinoma. However, when removed by endoscopic mucosal resection, tumors require careful examination to allow possible detection of DI in the resected specimen, i.e., to ensure complete tumor resection.

Multivariate analysis of 138 patients who died of recurrence after gastrectomy for gastric carcinoma indicated that the stage of disease or level of lymph node metastasis was an independent factor associated with the survival time. Patients with more advanced stage of disease or those with extended lymph node metastasis frequently died of recurrence within 2 years after gastrectomy.

The induction of a pneumoperitoneum decreases survival time by increasing tumor cell growth and decreases the efficacy of intraperitoneal chemotherapy. This effect appears to be reduced by the intraperitoneal use of heparin/taurolidine.

The presence of fibrous tissue between tumor and the surrounding hepatic parenchyma was noted in 93 of 152 patients (61%) who underwent hepatectomy for colorectal liver metastases. Clinicopathologically, the presence of such a fibrous pseudocapsule in patients with colorectal liver metastases was correlated with less invasiveness of the disease to adjacent vessels and a good prognosis after resection compared with patients without such a capsule.

In this study, the therapeutic efficacy of microwave coagulation in the treatment of hepatic metastases from colorectal carcinoma was compared with that of hepatic resection. It is suggested that microwave coagulation is equally effective as hepatic resection in terms of a survival rate, whereas the surgical invasiveness of this technique is less than that of hepatic resection.

This study examined whether the site of a primary colon carcinoma would influence the anatomic distribution of metastases within the liver. No significant difference in seeding of metastases to the right or left hemiliver could be identified when patients who had right- or left-sided colorectal carcinoma were compared.

The responses and survival of patients with isolated, nonresectable liver tumors who receive regional hepatic arterial infusion chemotherapy may be predictable with thymidylate synthase quantitation and in vitro chemosensitivity testing.

Heterozygotes for missense mutations in the HFE gene are overrepresented among patients with hepatocellular carcinoma undergoing surgical resection; these patients may represent a cirrhotic subgroup with reduced survival for whom surgical resection of the tumor might not be the best treatment option.

In patients with advanced pancreatic carcinoma, arterial infusion chemotherapy after vascular supply distribution via superselective embolization was effective against both primary tumors and metastatic liver lesions.

Chemoradiotherapy followed by resection, when possible, is associated with less early mortality and appears to increase survival from the time of diagnosis for patients with pancreatic tumors reliably staged as unresectable. Preoperative chemotherapy and/or radiotherapy for earlier resectable stages of pancreatic carcinoma require further investigation.

Thirty-nine elderly or poor performance status patients with advanced, previously untreated nonsmall cell lung carcinoma received weekly treatment with docetaxel. Treatment was well tolerated, resulted in minimal myelosuppression, and produced a response rate of 18% with a 1-year survival rate of 27%.

Macrophage migration inhibitory factor (MIF) is highly expressed in both the cytoplasm and nucleus of lung adenocarcinoma cells. Decreased MIF expression in the nuclei is correlated significantly with poor prognosis in patients with lung adenocarcinoma.

Physician detection and family history are associated with presentation in patients with early melanoma.

Melanoma mortality in Sweden has leveled off since the mid-1980s. During the period 1987–1996, a statistically significant downward trend was observed for females. Educational campaigns may have contributed to these trends.

Mania and mood instability are underdiagnosed side effects of adjuvant interferon therapy for melanoma patients. Recognition and treatment of these syndromes has the potential to improve quality of life in this patient population.

Skeletal complications in women with metastatic breast carcinoma are extremely common, frequently occur multiple times in a single patient, and predate patient death by 1 year or more in women with any bone disease at the time of presentation of metastatic disease. Bone involvement at the time of initial presentation of metastatic disease was found to be the sole independent predictor of skeletal complications on multivariate analysis.

Among postmenopausal women, increased weight or body mass index and mammographically dense breast tissue are significant independent breast carcinoma risk factors. Overweight women with dense breasts may be at particularly high risk.

This case-control study does not appear to support the hypothesis that folate, homocysteine, or B₁₂ are markers of risk for cervical dysplasia. A possible inverse association between plasma cysteine concentrations and the risk of cervical dysplasia is suggested.

Ovarian tissues removed prophylactically from women with germline mutations of BRCA1 were compared with ovarian tissues from control subjects for the frequency of premalignant morphologic alterations and alterations in molecular and cell biologic markers associated with ovarian tumorigenesis. No differences were observed between the two groups with regard to any of these features, indicating that premalignant alterations in ovaries from BRCA1 heterozygotes are rare.

Advanced disease in young patients with malignant ovarian germ cell tumors should not necessarily contraindicate conservative surgery. The majority of these patients who have received combination chemotherapy resume normal ovarian function and can expect a normal fertility rate and healthy offspring.

The purpose of the current study was to demonstrate treatment outcome and the long term treatment toxicity in patients treated with hyperthermia and external beam radiation therapy for locally advanced prostate carcinoma. Overall, both the pretreatment prostate specific antigen (PSA) level and the PSA nadir reached were statistically significant for biochemical no evidence of disease status, whereas the duration of hyperthermia showed a trend toward significance for overall survival. No patients were reported to develop long term morbidity from the addition of the hyperthermia therapy.

High sensitivity and specificity of transglutaminase may provide a useful adjunct to pathology in benign prostate biopsies.

Length of hospital stay is one of the main contributors to the cost associated with radical prostatectomy for localized prostate carcinoma. The authors present a comprehensive analysis of factors contributing to the length of hospital stay after radical prostatectomy that they believe demonstrates that the impact of such factors is highly dependent on the surgical approach chosen for radical prostatectomy.

Paclitaxel at a dose of 150 mg/m² weekly for 6 weeks every 8 weeks has clinical activity in patients with hormone-refractory prostate carcinoma. Peripheral neuropathy is the major toxicity of this regimen.

Survival analysis of 6311 incident head and neck cancer patients in the Bombay population during the years 1987–1991 revealed a 5-year relative survival rate of 36.7% and survival ranging from 25.5% to 74.5% for component subsites. Though early detection linked with adequate local treatment can further improve prognosis for patients with head and neck cancer, primary prevention by tobacco and alcohol control is an important long term measure.

Telomerase activity is found at varying levels in all types of B-cell non-Hodgkin lymphoma, except for low grade marginal zone lymphomas, including mucosa-associated lymphoid tissue types. However, it is not constitutively active and appears to be under proliferative control.

Increasing tumor thickness, ulceration, and a high mitotic index are useful predictors of sentinel lymph node biopsy results in patients with melanoma, but these variables do not appear to predict the presence of residual disease in the lymph node basin after a positive sentinel lymph node biopsy.