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Query: UMLS:C0006826 (
cancer
)
1,092,456
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
There is no reliable method to determine the
malignancy
degree of a tumour. Histology is not accurate.
TNM
classification is very interesting for planning surgical technique but gives little information about
cancer
aggressiveness. Flow-cytometry is a new technique to measure nuclear DNA quantity with great reproducibility and sensitivity. A normal cell is diploid (2N chromosome) and a tumoral one aneuploid. DNA quantitation is possible on fresh as well as on histological samples stored in formaldehyde or paraffin. Aneuploidy reflects the
cancer
aggressiveness. Aneuploidy is also correlated with
TNM
classification. Aneuploid tumors could require a more "aggressive" treatment regardless their size.
...
PMID:[The value of flow cytometry in the prognosis and treatment of head-and-neck cancers. Preliminary studies]. 156 21
Analyses of tumor size and breast cancer stage were used to determine whether biased detection of breast cancer could have materially influenced estimates of risk associated with use of oral contraceptives. In a population-based case-control study conducted from 1980-1982, surveillance for breast cancer by breast exams, but not mammography, was found to be strongly linked to use of oral contraceptives. Tumors were slightly smaller and less likely to be late-stage (
TNM
stage III or IV) in patients who had used oral contraceptives. The net effect of any diagnostic bias on advancing the date of
cancer
diagnosis, whether from breast exams or other sources, was estimated to be less than 8 weeks. This corresponds to spuriously increasing the risk of early-occurring breast cancer in oral contraceptive users by at most 2.4% (relative risk = 1.024).
...
PMID:Breast cancer detection in relation to oral contraception. 158 51
From 1988 to 1990, 53 patients with squamous cell carcinoma of the thoracic oesophagus underwent subtotal oesophagectomy after either preoperative hyperthermo-chemoradiotherapy (HCR therapy) or chemoradiotherapy without hyperthermia (CR therapy), in a prospective randomized trial carried out to examine the effects of hyperthermia given preoperatively. The two groups (27 patients given HCR therapy and 26 given CR therapy) were found to be comparable with regard to prognostic factors of age, site of carcinoma,
TNM
stage, etc. Following preoperative evaluation by an upper GI series and endoscopy, a subtotal oesophagectomy was done for all 53 patients. All the resected specimens, including the lymph nodes, were histopathologically examined, and the effects of preoperative treatment were evaluated by findings in the upper GI series and endoscopy, as well as based on the histopathology of the excised tissues. There were no viable
cancer
cells in the resected specimens of seven patients in the HCR therapy group (26.9%) and of two patients in the CR therapy group (7.7%). In addition, no hyperthermia complications were observed. The study suggests that preoperative HCR therapy may be a more beneficial therapy than preoperative CR therapy in patients with squamous cell carcinoma of the oesophagus who undergo a subtotal oesophagectomy.
...
PMID:Hyperthermia combined with chemotherapy and irradiation for patients with carcinoma of the oesophagus--a prospective randomized trial. 160 33
The role of the tumor registrar in
TNM
staging has not been clearly defined. This paper shows how this can be clarified in individual hospital
cancer
programs and how the tumor registrar serves as a key member of the
cancer
team in implementing physician
TNM
staging.
...
PMID:Tumor registrar's role in TNM staging. 161 60
The results of expressing patient outcome are compared using two staging systems: localized, regional, and distant (LRD) and the
TNM
of the American Joint Committee on
Cancer
(AJCC). Expressing patient outcome depends on the staging system used. There is overlap between the stage definitions of the LRD and the
TNM
. A single stage in the LRD may include more than one stage grouping of the
TNM
and vice versa. For most sites, "localized" provides lower survival rates than stage I of the
TNM
. The
TNM
provides more precise information about prognosis because its definitions reflect the latest survival information and diagnostic technology. Time trends can be measured only with the LRD because of its stability over the years. The precision of the
TNM
has been achieved at the expense of time trend analysis. The LRD is usually not an acceptable end point for the assessment of early
cancer
detection.
...
PMID:Survival results depend on the staging system. 161 64
From 1977 to 1987, 277 patients with velotonsillar
cancer
(oropharyngeal cancer excluding base of tongue and valleculae) were treated by brachytherapy either alone (14 patients) or combined with external beam irradiation (263 patients) using a new afterloading Iridium-192 technique. The distribution of patients according to the localisation was as follows: 106 tonsillar region, 98 soft palate, 45 anterior pillar, 8 posterior pillar and 20 pharyngoglossal sulcus. According to the UICC
TNM
classification of 1979, the patients were staged as follows: 65 T1, 103 T2, 101 T3, 8 TX. 172 patients were NO, 74 N1, 3 N2, 20 N3 et 8 NX. According to the tumor extension, the 5 year actuarial local control, locoregional control, specific survival and overall survival by T stage (T1 [65 pts], T2 [103 pts.], T3 [101 pts]) were respectively: local control: 89%, 86%, 69%; locoregional control: 84%, 80%, 67%; specific survival (excluding patients dead with intercurrent disease or second cancer): 78%, 62%, 46%; overall survival: 62%, 53%, 43%. No local recurrence was detected after 3 years. According to the localization, the tumors arising from the tonsillar region, the soft palate and the posterior pillars (A Group) had a better prognosis than the tumors arising from the anterior pillars and glossotonsillar sulcus (B Group). The complications were classified into four grades according to their extension and duration: Grade 1 (minor) with very small tissue ulcer which healed within 2 months with medical treatment (20%). Grade 2 (moderate) (5%), grade 3 (severe) (1.4%), grade 4 (fatal) (0.4%). The dose rate seemed to be relatively higher in patients with grade 2 and 3 complications (70 cGy per hour on average) versus the dose rate of patients without complications (50 cGy per hour) but the difference was not significant. In conclusion, the brachytherapy boost after external irradiation can be performed under favourable conditions with an acceptable rate of complications. It was set out in order to attempt to improve the local control of the tumor while preserving the salivary function and lessening the muscular fibrosis. It shows how experienced the team is, however only a randomized study would allow to state whether this technique brings about a real improvement especially as for tumors T2 or T3.
...
PMID:Velotonsillar squamous cell carcinoma: 277 cases treated by combined external irradiation and brachytherapy--results according to extension, localization, and dose rate. 161 63
Between January 1, 1983, and December 31, 1988, operations were performed on 112 patients with adenocarcinoma of the gastric cardia. Resection of the primary tumor was performed in 93 patients. For these 93 patients, follow-up until July 1, 1989, averaged 24 months, during which time 59 patients died. Positive resection margins carried a greater risk for the development of a local recurrence but did not correlate with survival. The cumulative overall 5-year actuarial recurrence rate was 69%. The cumulative 5-year recurrence rate for metastases was 64% and for locoregional recurrence it was 36%. The overall 5-year survival rate was 24%. Differences in survival were observed between patients with carcinomas of the various subgroups of the 1987
TNM
classification system (T1-T2 versus T3-T4, N0 versus N1-N2, M0 versus M1, Stages I-II versus Stages III-IV, Grades 1-2 versus Grades 3-4). In particular, lymph node status as correlated with histopathologic grade showed remarkable differences in survival: patients with no positive lymph nodes in the resection specimen and a Grade 1 or 2 tumor had a significantly better 5-year survival rate (53%) than the other subgroups (N0/Grades 3-4: 21%; N1-N2/Grades 1-2: 12%; N1-N2/Grades 3-4: 14%).
Cancer
1992 Aug 01
PMID:Adenocarcinoma of the gastric cardia. Recurrence and survival after resection. 162 72
In a prospective interview study, designed to compare the psycho-social outcome after a breast-conserving vs. a mastectomy operation, we analysed possible predictors of the psycho-social adjustment. 99 women with breast cancer histopathological
TNM
stages I and II were consecutively admitted to the study. Half-structured interviews, based on the Social Adjustment Scale and a scale by P. Maguire, were performed 4 and 13 months after the operation. Living together with the spouse seems to protect women from developing psycho-social problems postoperatively. Women who were gainfully employed or who were given radiotherapy had a higher risk of poor adjustment after 4 months. At 13 months, the scorings indicate that radiotherapy has a reassuring effect. Type of surgery was controlled for in the analysis and showed that, of the risk factors studied, the most consistent trend for an overall better outcome was in the breast-conserved group except for sexual disturbances.
Eur J
Cancer
1992
PMID:Determinants of the psycho-social outcome after operation for breast cancer. Results of a prospective comparative interview study following mastectomy and breast conservation. 162 76
In a prospective randomized clinical trial conducted by the European Organization for Research and Treatment of
Cancer
(EORTC), mastectomy was compared with breast-conserving therapy in 903 stage I and stage II breast cancer patients entering the study between 1980 and 1986. The main participating centers were: Guy's Hospital, London; The Netherlands
Cancer
Institute, Amsterdam; University Hospital, Leuven; Radiotherapy Institute, Rotterdam; Breast Unit, Tijgerberg, S.A. The data were collected in the EORTC Data Center, Brussels. Treatment in the study arm consisted of lumpectomy, axillary clearance, and radiotherapy to the breast (50 Gy external irradiation in 5 weeks followed by boost with iridium implant of 25 Gy). Important in this study is the large number of
TNM
stage II patients (755). Most patients were stage II because of the size of the tumor (2-5 cm). The patient and tumor characteristics in the study and control groups were well balanced. So far the survival curves and local recurrence rates are not statistically different for the two study arms. Tumor size was found in univariate analysis to be a significant risk factor for local recurrence in the breast-conserving therapy group but not in the mastectomy group. Results of salvage treatment for local recurrence were not better for the breast-conserving therapy group compared with the mastectomy group. Measurements of quality of life and cosmesis show a clear benefit for the breast-conserving therapy group.
J Natl
Cancer
Inst Monogr 1992
PMID:Randomized clinical trial to assess the value of breast-conserving therapy in stage I and II breast cancer, EORTC 10801 trial. 162 21
The accumulating data show that endoscopic ultrasonography (EUS) is highly compatible with the UICC/AJCC staging classification for esophageal and gastric cancer, based on the
TNM
system expressing anatomical extent of disease. The great strength of EUS in staging these cancers is its ability to image the gut wall and adjacent structures in unique detail. EUS is more accurate than computed tomography in staging the depth of primary tumor invasion (T) and regional lymph node metastases (N). High frequency EUS is not useful in staging for distant metastases (M) due to limited depth of the field. EUS also has limitations in reliably distinguishing between neoplastic and inflammatory tissue. Thus, the major use of EUS is in staging rather than in diagnosis. However, initial reports indicate that EUS may be helpful in the detection of
malignancy
in Barrett's esophagus, in diagnosing post-operative recurrent cancer, and in evaluating the response to non-operative therapy. EUS appears to represent an important advance in the staging and follow-up of patients with esophageal and gastric cancer. Instruments and techniques will continue to evolve, but the next level of research should be designed to show that the improved staging provided by EUS has clinical utility and can affect patient outcome.
...
PMID:Endoscopic ultrasonography in the diagnosis, staging and follow-up of esophageal and gastric cancer. 163 69
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