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Query: UMLS:C0007097 (carcinoma)
 152,788 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One of the major short comings of the traditional TNM system is its limited potential for prognostication. With the development of multifactorial analysis techniques, such as Cox's proportional hazards model, it has become possible to simultaneously evaluate a large number of prognostic variables. Cox's model allows both the identification of prognostically relevant variables and the quantification of their prognostic influence. These characteristics make it a helpful tool for analysis as well as for prognostication. The goal of the present study was to develop a prognostic index for patients with carcinoma of the upper aero-digestive tract which makes use of all prognostically relevant variables. To accomplish this, the survival data of 800 patients with squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx or larynx were analyzed. Sixty-one variables were screened for prognostic significance; of these only 19 variables (including age, tumor location, T, N and M stages, resection margins, capsular invasion of nodal metastases, and treatment modality) were found to significantly correlate with prognosis. With the help of Cox's equation, a prognostic index (PI) was computed for every combination of prognostic factors. To test the proposed model, the prognostic index was applied to 120 patients with carcinoma of the oral cavity or oropharynx. A comparison of predicted and observed survival showed good overall correlation, although actual survival tended to be better than predicted.
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PMID:Using Cox's proportional hazards model for prognostication in carcinoma of the upper aero-digestive tract. 160 11

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.
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PMID:Hyperthermia combined with chemotherapy and irradiation for patients with carcinoma of the oesophagus--a prospective randomized trial. 160 33

An attempt is made to establish the most appropriate examination procedure for staging rectal carcinoma by computed tomography (CT). Twenty-two patients with rectal carcinoma had CT performed preoperatively. The following three CT sequences were performed in all patients: a precontrast scan with 10-mm slices; a rapid sequence scan with 5-mm slices during bolus injection of contrast medium; and a postcontrast scan after a 10-min delay. Tumor extension and the presence of perirectal lymph nodes were evaluated separately and independently in all three CT sequences according to the TNM classification. All patients had surgical follow-up and the CT scans were compared to the surgical and histopathological findings. There was no significant difference in diagnostic outcome in the three CT procedures. Information obtained by frontal and lateral scout views were compared, and the lateral scout view proved more informative than the frontal scout view. For staging rectal carcinoma, narrow slice scanning and intravenous contrast media are superfluous and should be reserved for special cases. We recommend the use of lateral scout views.
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PMID:Comparison of precontrast, postcontrast, and delayed CT scanning for the staging of rectal carcinoma. 161 14

The penis carcinoma is a neoplasia representing 0.7% of all male neoplasias, with an annual incidence between 1 and 2 cases per 100,000 inhabitants/year. The present study compiles the authors' experience in treating 22 patients presenting this neoplasia in the period between 1977-90. The procedures carried out included local resection, partial amputation, radical penectomy with lymphadenectomy plus radiotherapy, and palliative surgery plus radiotherapy all based on staging made following TNM grading. Therapy complications, follow-up, and survival results are explained. There were 5 occasions of spinocellular carcinoma co-existing with other neoplasias: 1 colon adenocarcinoma, 1 prostate carcinoma, 1 cleaved small cell centrocytic diffuse lymphoma, and 2 skin epithelioma in other sites, and relevant literature was reviewed. A background of psoriasis treated with psoralens plus UV was present in 4 cases, and caution was advised towards genital protection in patients undergoing UV radiations whether for therapeutic, recreational or cosmetic reasons.
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PMID:[Carcinoma of the penis. Our experience with 22 cases]. 162 46

The aim of regular follow-up of cancer patients after curative surgery is to detect any recurrence or second cancer as early as possible. Some workers have claimed that in such cases prompt surgical therapy can cure large numbers of patients. To answer this question, a detailed follow-up programme was carried out in 1054 patients (585 men, 469 women, mean age 62 [25-79] years) who had undergone surgery for colorectal cancers in TNM stages I, II, or III, the operations having been aimed at cure, not merely palliation. During a median observation time of 38 (4-140) months recurrences arose in 350 patients, while 16 patients developed a second carcinoma and 23 patients a carcinoma of some other organ. In 75 of the 350 patients there was an isolated local or regional recurrence, but in 275 patients there were distant metastases. Second operations aimed at cure were performed in 56 of the 350 patients. Only 21 of these 56 patients, i.e., 6% of all the patients whose tumours recurred, were free from cancer at the end of the observation period. The effort and expense required for a cancer follow-up programme of the kind at present advocated for patients with colorectal cancer are out of proportion to the results achieved. This conclusion should prompt a review of the value of other follow-up programmes.
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PMID:[Does tumor aftercare in colorectal carcinoma make sense?]. 164 41

Between 1976 and 1989, 53 out of 60 patients with large cell carcinoma of the lung underwent potentially curative surgery, i.e. macroscopically and microscopically complete resection. For better comparison, all tumors were classified according to the TNM staging system of the UICC 4th edition of 1987. Following potentially curative surgery, in stage I the mean survival time was 19 months and the five-year survival rate 30.1%, in stage II 8 months and 10%, and in stage IIIa 6.5 months and 0%, respectively. The differences in the long term prognosis between the tumor stages are significant. No significant differences could be demonstrated between II and IIIa in terms of the mean survival times. The prognosis for patients with potentially curatively resected squamous cell carcinoma is significantly better than that for patients with large cell carcinoma.
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PMID:Large cell carcinoma of the lung: a contribution on prognosis after potentially curative resection. 165 78

The DNA content was analysed by flow cytometry in 5 samples of normal salivary tissue, 36 cases of benign salivary gland tumors and 50 cases of parotid carcinoma. It was found that the difference in the DNA index (DI) and proliferative index (PI) in age, sex, tumor size and TNM staging were insignificant (P greater than 0.05). The DI and PI of poorly differentiated parotid carcinoma were much higher than those of well differentiated parotid carcinoma (P less than 0.05). The DI and PI were closely related to the presence of lymph node metastasis (P less than 0.001). The DI and PI of patients with facial nerve paralysis and with disease free period shorter than 5 years were remarkably higher than those with normal facial nerve and disease free survival for more than 5 years (P less than 0.01). The above results indicate that DI and PI, showing cell proliferative kinetic characteristics, can provide reliable and objective parameters for assessing the degree of differentiation, degree of malignancy, biological behavior and prognosis of parotid carcinomas.
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PMID:[Biological significance of DNA content in parotid carcinoma]. 166 20

In 62 patients with thyroid carcinoma 79 MRI bone marrow examinations and 48 bone marrow scintigraphies were recorded before or following radioiodine therapy, to study the extent of bone marrow expansion. The results of both methods were the same. In 34/79 investigations normal findings were seen, in 18 the bone marrow expanded to the middle third and in 26 to the distal third of the femur. One patient showed bone marrow expansion to the tibia. These results were compared with the following data: histology of tumor, TNM-staging, time passed since thyroidectomy, accumulated doses of radioiodine therapy, results of 131I scintigraphy, hematological changes, thyroglobulin level, age and sex. No significant correlations were found between these and the bone marrow imaging results. Bone marrow changes in patients before radioiodine therapy were similar to those in patients treated with up to 48 GBq 131I. Blind biopsy of the posterior iliac crest in five patients showed slightly pathological reactive changes. In only 2/17 follow-up studies an increase of bone marrow expansion was seen. In 8 patients localized findings indicating malignant infiltration were observed. In 4/8 patients metastases of thyroid carcinoma were known or confirmed by pathological radioiodine uptake and in 2/8 metastatic involvement was assumed because of an increased thyroglobulin level.
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PMID:[Bone marrow changes in patients with thyroid carcinoma]. 178 Feb 40

A total of 605 cases of the carcinoma of gastric cardia resected were analysed univariantly using program of analysis for risk states and survival analysis by life table method on IBM-PC computer. The significance of lymph nodes metastasis in different situations concerning prognosis was evaluated. Our results suggest that the lymph nodes with metastasis at the lower part of esophagus should be grouped as N 1 in the TNM staging system for carcinoma of the gastric cardia. We propose a new staging method, using number of lymph nodes metastasis and degree of tumorous infiltration to the adjacent organs as main indices, for the advanced carcinoma of the gastric cardia clinically and pathologically.
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PMID:[The study of lymph nodes metastasis and staging of carcinoma of the gastric cardia by computer]. 178 51

We have reviewed retrospectively the records of 157 patients, less than or equal to 30 years of age with nasopharyngeal carcinoma (NPC) from 218 such cases identified in the tumor registry files of three major teaching hospitals in Taipei, Taiwan. These cases were diagnosed between 1 January 1982 and 31 December 1985, with a minimum follow-up of 2 years. The average age was 25, with a male/female ratio of 1.67. The TNM (tumor size, nodes, metastases) classification of 127 patients showed T1, 22%; T2, 33.1%; T3, 23.6%; T4, 21.3%; N0, 26%; N1, 16.5%; N2, 27.6%; N3, 30%; and M1, 13.4%. Antibody titer to Epstein-Barr virus capsular antigen (EBVCA) were elevated in 45 of 48 patients tested. Of the 29 patients who had hepatitis B (HB) viral survey done 34.5% were positive for HB surface antigen (HBsAg). Of 13 patients with elevated EBVCA antibody who were also tested for HB, six were HBsAg carrier. Actuarial survival rates of 2 and 3 years are 70 and 62%, respectively, among the 90 patients who were followed regularly or to death. HBsAg carriers and patients with M1 disease had a shorter survival time. We concluded that patients less than 30 years of age seemed to have an increased incidence of NPC, compared to that in an earlier report. Our patients frequently presented with advanced stage and poor prognosis. The high rate of HB carrier raises the possibility that HBV may play a role in the carcinogenesis and tumor growth in some NPC patients. Future prospective studies are needed.
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PMID:Nasopharyngeal carcinoma in young patients. 184 56


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