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

In the past, neck dissections have been recommended only when nodes were clinically palpable or when they became so. A retrospective ten year study of thirty-seven patients with carcinoma of the lip and with an unusually high mortality has allowed reevaluation of indications for neck dissection. (1) Ten of thirty-seven patients died of this disease and nearly all of the ten died with and because of regional metastases. (2) Seven patients with nonpalpable nodes initally had nodal metastases later which, despite neck dissection at that later time, proved lethal. (3) Two patients who, despite nonpalpable nodes, had undergone neck dissections and were found to have occult bilateral nodal metastases were effectively cured with early neck dissection. This suggests that early bilateral supramohyoid neck dissections for small carcinomas of the lip and ipsilateral radical neck dissections for large primaries may yield higher cure rates than currently achieved.
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PMID:Indications for neck dissection in carcinoma of the lip. 83 95

Survival after partial pancreaticoduodenectomy (Whipple procedure) for carcinoma of the pancreas is uniformly poor. In the absence of nodal metastasis this may be due to extension of tumor beyond the line of resection of the pancreas or to a multicentric origin of the tumor. The material reviewed contained an illustration of the latter circumstance and provides a logical reason for recommending total pancreatectomy as the procedure of choice in resectable pancreatic carcinoma.
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PMID:Total pancreatectomy for carcinoma of the pancreas. 83 1

During the ten year period of this retrospective study, 66 of 1,451 patients with carcinoma of the colon and rectum had carcinoma of the cecum. The most frequent symptoms were nonspecific and caused by anemia which, in some instances, were treated without adequate investigation. The standard and most appropriate treatment for carcinoma of the cecum is a right hemicolectomy with ileotranversostomy and, when necessary and feasible, en bloc resection of involved parts of the abdominal wall. In the absence of nodal disease or distant metastases, extension to the abdominal wall does not adversely influence the prognosis. The surgeon must remain aware of the possibility of coexisting carcinoma of the cecum and appendicitis. Any patient with a mass or a persistent draining sinus after an appendectomy or drainage of an appendical abscess should be suspected of having carcinoma of the cecum. The over-all five year survival rate in this series is 33%, and if curative resections alone are considered, it is 44%, with an operative mortality of 3%. More recent evidence indicates that there has been a shortening of the delay in treatment, and we believe future studies will show an improvement in these figures.
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PMID:Carcinoma of the cecum. 84 3

One hundred twenty-five patients with a history of prior irradiation to the head and neck region for benign disease underwent thyroidectomies between 1967 and 1976 at Evanston Hospital. One hundred twenty-four had a palpable abnormality. Forty-two had carcinoma, and nine of these had nodal metastases. Palpation was found to be more accurate than thyroid isotope scan in finding carcinoma within an abnormal gland. Some form of irradiation thyroiditis was found in one half of the resected specimens.
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PMID:Thyroid disease following irradiation for benign conditions. 84 45

Pelvic lymph nodes from 80 patients with primary invasive cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy were evaluated morphologically. Six to 25 (mean 14) lymph nodes from each patient were examined histologically and classified as follows: lymphocyte preominant, germinal center predominant, unstimulated, or lymphocyte depleted. Tumors were classified according to their primary cell type: large cell non-keratinizing, keratinizing squamous cell, small cell, and adenocarcinoma. There was no direct relationship between lymph node morphology and patient age, lesion size, or tumor cell type. A lymphocyte predominant nodal pattern was associated with a statistically significant decrease in lymph node metastases, and tumor recurrence, and an increase in patient survival. In contrast, patients with a lymphocyte depleted nodal pattern had a high incidence of metastatic disease and tumor recurrence, and a decreased survival. Patients with lymph nodes showing an unstimulated or germinal center predominant pattern had an intermediate incidence of nodal metastases and tumor recurrence. These findings suggest that regional lymph nodal morphology may be of prognostic significance in patients with invasive carcinoma of the uterine cervix.
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PMID:The prognostic significance of pelvic lymph node morphology in carcinoma of the uterine cervix. 87 61

Histologic features of the primary tumor and their effects on the incidence of unsuspected pelvic lymph node metastases have been studied in a prospective series of 62 patients with clinical stage B1, B2, or C prostatic adenocarcinoma who underwent pelvic lymph node removal. Twenty-one patients (34%) proved to have unsuspected nodal metastases. Differentiation of the primary tumor and extent of involvement of the prostate by carcinoma were the only two features that correlated significantly with the incidence of pelvic nodal metastases, 56% of those with undifferentiated tumors had metastases. Thirty-one of these patients underwent total prostatectomy; an average of only 46% of the sections of prostate contained tumor in the patients without metastases but an average of 65% of the sections were involved by carcinoma in those patients who did have nodal metastases.
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PMID:Clinicopathologic features of unsuspected regional lymph node metastases in prostatic adenocarcinoma. 90 39

The surgical tissues and clinical records of 54 surgically treated patients with microinvasive carcinoma of the cervix were retrospectively analyzed. Utilizing a definition that limited microinvasion to a depth of 3 mm, and excluded lymphatic and blood vascular involvement, the incidence of regional metastases in 37 patients for whom lymph nodes were available for study was 0%. Confluence of microinvasion did not imply a greater potential for metastatic spread or a worse prognosis. Lymphatic and blood vascular permeations were associated with nodal metastasis in one of four lesions which otherwise were microinvasive. Random cervical biopsy alone was inadequate for the diagnosis of microinvasion. Cone biopsy demonstrated an accuracy of 83% in diagnoses, but failed to eliminate intraepithelial or microinvasive carcinoma in 78% of the hysterectomy specimens. It is concluded that microinvasive carcinoma, as defined in this study, can be effectively treated by conservative rather than radical means.
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PMID:Microinvasive squamous carcinoma of the cervix: definition, histologic analysis, late results of treatment. 90 2

Chest wall and regional nodal recurrences, and survival following postmastectomy radiation therapy, were analyzed in 352 patients. Patients with T1 and T2 central and medial breast lesions, negative axillary nodal findings, and no evidence of skin or chest wall extension received irradiation to the peripheral lymphatics alone. There were no chest wall recurrences among these patients. The remainder of the patients, including those with axillary nodal involvement, regardless of the site of the primary breast lesion received irradiation by a three-field technique directed to both chest wall and regional nodes. The chest wall recurrence rate was 1.9% when axillary nodes were negative for metastatic disease, 1.3% when the axillary nodes showed less than 50% positivity, and 14.2% when axillary nodes showed greater than 50% involvement. The overall chest wall recurrence rate was 5.1%. A possible mechanism of chest wall recurrence is discussed. Cumulative 5-year survival for stage I is 76%, for stage II, 79%, and for stage III, 57%. If chemotherapy proves to be effective in controlling distant microscopic disease local control may become an equally critical issue in long-term survival of patients with breast carcinoma.
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PMID:The role of postoperative irradiation in carcinoma of the breast. 94 86

After all records of patients with breast cancer who received primary treatment at Memorial Hospital in 1960 were reviewed, 304 women with operable, infiltrating carcinoma were identified and classified clinically according to the TNM system of the American Joint Committee for Cancer Staging and End Results Reporting. There were 66 patients (22%) classified under Stage I, 176 (58%) under Stage II, and 62 (20%) under Stage III. There were 82 patients (27%) in whom the nodal status was misclassified clinically. The observed 10-year survival was 59.7%. The 10-year end results (with 95% confidence limits) diminished significantly in relation to advancing clinical stage of disease--90.9% (+/-6.9%) for Stage I, 57.1% (+/-7.3%) for Stage II, and 33.9% (+/-11.8%) for Stage III patients. The 10-year survival in patients with pathologically negative axillary nodes was 71.5%, and in the patients with pathologically positive axillary nodes, 48.3%.
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PMID:Ten-year results of the treatment of primary operable breast carcinoma: A summary of 304 patients evaluated by the TNM system. 97 86

Xeroradiographic evaluation of the axilla is useful in the presence of mammary carcinoma, as radiographic examination of this area can be highly accurate in predicting its malignant involvement if certain strict criteria are employed. The ability to diagnose nodal metastases with near certainty has important implications for treatment planning and prognostication.
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PMID:Clinicopathological correlations of xeroradiography in determining involvement of metastic axillary nodes in female breast cancer. 98 9


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