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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The over-all 3,5 and 10-year survival rate for 87 patients with non-seminomatous germ cell tumors of the testis undergoing retroperitoneal lymphadenectomy was 90.5 per cent. Of the 72 patients receiving no form of therapy other than retroperitoneal lymphadenectomy after operative removal of the testicular tumor the 5-year survival rate was 90.8 per cent. The 5-year survival rates for these 72 patients, calculated according to the histologic characteristics of the primary tumor, were 74.4 per cent for 18 patients with embryonal carcinoma, 93.0 per cent for 36 patients with teratocarcinoma and 100 per cent for 18 patients with teratoma. Although no advantage could be demonstrated for bilateral lymphadenectomy as opposed to unilateral dissection, it is concluded that a modified bilateral dissection should be reserved only for tumors on the left side.
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PMID:Prognosis for pathologic stage I non-seminomatous germ cell tumors of the testis managed by retroperitoneal lymphadenectomy. 93 92

This paper presents the results of a retrospective clinical study of 250 cases of monocentric carcinoma of the mucosal surface of the cheek, i.e. all the primaries treated by radiotherapy at our Institute between January 1948 and December 1965. Neoplastic lesions found at follow-up were regarded as marginal recurrences if in the proximity of the treated area and as secondary tumors in other cases. From 1948 to 1957 conventional radium therapy was the usual treatment for the primary tumor whereas from 1958 to 1965 cobalt teletherapy was given most frequently. Surgery was reserved for lymph node metastases when present on clinical examination. In our experience radiotherapy is effective in cancers of the mucosal surface of the cheek, for it checked local spread in 50.9% of cases, however treated and regardless of initial clinical appearance, whereas in the T1-T2 cases the local failure rate dropped to 35.8%. The higher the T level the greater are the difficulties confronting radiotherapy; for more extensive lesions appropriate combination therapy (radiosurgical) in line with the well-defined rules explained in the text is useful. In our experience radiotherapy yields good long term results regardless of T level and even in the more unfavorable cases. Our study confirms the low rate of lymph spread of these carcinomas: over half of the patients were N0 before treatment; only 56.7% of the patients receiving surgical treatment on the neck had histologically positive lymph nodes; there were very few neck recurrences at follow-up; the presence of suspect or frankly metastatic nodes on clinical examination, being movable and homolateral (N1), did not worsen the prognosis. However, considering the techniques used for irradiation of the primary, some patients received a substantial dose to the neck; hence radiotherapy probably played its part in the low rate of neck metastases.
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PMID:[Results of radiotherapy in a series of 250 carcinomas of the mucosal surface of the cheek (author's transl)]. 103 Aug 65

Primary noncarcinomatous malignant neoplasms of the esophagus are uncommon and data concerning treatment and results are sparse. To evaluate the results of therapy in this group, we reviewed the records of 32 patients with primary esophageal malignant tumors of unusual histologic type. Thirteen patients (41%) had sarcoma, eight (25%) melanoma, and 11 (34%) had oat cell carcinoma. Dysphagia was present in 78% (25/32) of the patients for a median of 13 weeks before diagnosis. Location of the esophageal primary tumor was upper third in four patients (12%), middle third in 12 (38%), and lower third in 16 (50%). Treatment consisted of esophagectomy in 10 of 13 patients with sarcoma (77%), seven of eight with melanoma (88%), and three of 11 with oat cell carcinoma (27%). Patients not undergoing resection received chemotherapy or radiation therapy, or both. The 3- and 5-year survival rates were 46% and 23% for sarcoma (median 20 months), 13% and 0% for melanoma (median 5 months), and 0% and 0% for oat cell carcinoma (median 5 months), respectively. Distant disease was the initial form of recurrence in 73% (11/15) of patients undergoing curative therapy. Surgical resection appears indicated for localized primary esophageal sarcoma. Optimum treatment of primary esophageal melanoma is less clear, but surgical resection may be of benefit in selected patients. Esophageal oat cell carcinoma is a systemic disease necessitating systemic therapy with local therapy reserved for palliation of dysphagia.
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PMID:Unusual malignant neoplasms of the esophagus. Oat cell carcinoma, melanoma, and sarcoma. 170 94

The observed response of [131I]metaiodobenzylguanidine (131I-MIBG) therapy in advanced neuroblastoma after conventional therapy had failed, the noninvasiveness of the procedure, and the high metabolic activity of untreated tumors led to a new protocol to use 131I-MIBG therapy in newly diagnosed patients instead of combination chemotherapy prior to surgery. The objectives of this study are to improve the overall outcome of patients with neuroblastoma by introducing 131I-MIBG therapy as the first therapy in the treatment schedule, in order to reduce the tumor volume, enabling adequate surgical resection and avoiding toxicity and the induction of early drug resistance. The advantages of this approach are that the child's general condition is unaffected before surgical resection is performed and that chemotherapy is reserved to treat minimal residual disease. So far, 13 patients with inoperable neuroblastoma (stage III and IV) were treated with 131I-MIBG initially and then submitted to surgery. More than 50% decrease of the volume of the primary tumor was noted in 7 of 10 evaluable patients; 8 patients have so far been operated with complete resection in 2, greater than 95% resection in 5 and 80% resection in one patient. Three patients are still undergoing 131I-MIBG treatment. The toxicity of 131I-MIBG de novo is in contrast with the previous experience of 131I-MIBG therapy after conventional therapy: only 4 patients had thrombocytopenia and only 1 of 7 patients with bone marrow involvement developed bone marrow depression.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Preoperative [131I]metaiodobenzylguanidine therapy of neuroblastoma at diagnosis ("MIBG de novo"). 182 28

Extrarenal Wilms' tumors are rare and have mainly been the subject of isolated case reports. This retrospective evaluation of 34 patients suggests a clinical course very similar to that of renal Wilms' tumor. While clinical presentation varies according to the extrarenal localization, investigations to determine the size of the primary tumor (T), regional lymph node involvement (N), and the occurrence of distant metastasis (M) are very similar, ie, chest x-ray, abdominal ultrasound (US), and computed axial tomographic (CAT) scan of the abdomen and chest. Stage grouping according to the pathologic TNM classification showed stage I in 30%, stage II in 10%, stage IIIa in 34%, stage IIIb in 23%, and stage IVa in 3%; four patients could not be staged. Evaluation of therapy and survival indicate the need for postoperative chemotherapy (CT) to all patients, while the same data suggest that the drugs used for renal Wilms' tumor are equally effective for extrarenal Wilms' tumor. Radiotherapy (RT) probably should be reserved for those patients with unresectable gross residual disease and for metastatic disease. The radiation dose used in the reviewed cases varied from 2,000 to 5,000 cGy. However, recent experience suggests that high doses are not justified in renal Wilms' tumor. The estimated overall 2-year survival of the 34 patients is 82% (95% confidence interval, 63% to 92%).
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PMID:Extrarenal Wilms' tumor: staging, treatment, and prognosis. 184 74

The role of interstitial implantation in the radiotherapeutic treatment of base of tongue carcinoma remains controversial. At the University of Florida, essentially all patients with base of tongue cancer have been managed initially by radiation therapy (with or without neck dissection) with operation reserved for radiation therapy failure. Eighty-four patients with invasive squamous cell carcinoma of the base of the tongue were treated with continuous-course external-beam irradiation without interstitial implantation between October 1964 and July 1986. Treatment was administered once-a-day in 59 patients and twice-a-day in 25 patients. The median follow-up was 99 months (range, 25-284 months). No patient was lost to follow-up. Local failure occurred in 1/9 patients (11%) with T1 lesions, 3/30 (10%) with T2, 6/31 (19%) with T3, and 9/14 (64%) with T4. If one excludes from the local control analysis those patients who died of intercurrent or metastatic disease within 2 years with their primary tumor continuously controlled, then the rates of local control are as follows: T1, 3/4; T2, 22/25 (88%); T3, 20/26 (77%); T4, 5/14 (36%). An improved local control rate for T4 tumors was noted with twice-a-day fractionation. Eighty-eight percent of N0-N1 necks and 79% of N2-N3 necks were treated successfully by irradiation with or without planned neck dissection. Five-year rates of continuous disease control above the clavicles were as follows: Stage I-II, 100%; Stage III, 72%; Stage IVA, 78%; Stage IVB, 44%. Five-year absolute and relapse-free survival rates for the entire group were 43% and 58%, respectively. The incidence of bone exposure was 6%, and that of soft-tissue necrosis was 19%. In all but one case, the complication was mild to moderate in severity and healed with conservative management. These results compare favorably with those recently published in the literature supporting moderate-dose external-beam irradiation combined with interstitial implantation. We conclude that interstitial implantation is not essential for the successful radiotherapeutic treatment of base of tongue carcinoma.
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PMID:Is interstitial implantation essential for successful radiotherapeutic treatment of base of tongue carcinoma? 175 Sep 3

Radiation therapy and limited resection give equally good results in early squamous cell carcinomas of the nasal vestibule, each producing local control rates of 90% or more. For more extensive disease, primary radiation therapy with surgery reserved for residual or recurrent carcinoma is recommended in view of the significant cosmetic defects which generally follow major resection. Small and superficial lesions can be treated by external beam therapy or interstitial implants. Large or infiltrative lesions are best managed by external beam therapy. Serious late morbidity following irradiation is uncommon and has been reported in fewer than 5% of patients. Regional nodal metastases are diagnosed at the time of first presentation in about 5% of patients and signal a very poor prognosis. However, the data available do not support elective treatment of clinically uninvolved regional nodes. Fewer than 5% of patients manifest late nodal metastases when the primary tumor area remains free of recurrence, and most of these metastases can be controlled by neck dissection and/or irradiation.
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PMID:The place of radiation therapy in the treatment of squamous cell carcinoma of the nasal vestibule. A review. 304 44

The use of imaging procedures for breast cancer staging and follow-up should be based on the natural history of the disease as well as the accuracy, cost, and availability of the studies themselves. Early detection of metastases may provide palliation but probably does not affect survival. For staging, chest X-ray and mammogram are both recommended on all patients; radionuclide bone scan is advised in the presence of either an elevated alkaline phosphatase, axillary metastases, or a primary tumor measuring more than 2 cm; abdominal CT should be performed if liver chemistries are abnormal; CT brain scan is the procedure of choice for neurological symptoms. Chest CT should be reserved for selected patients with an abnormal chest X-ray. Follow-up recommendations include annual chest X-rays and mammogram, bone scans every 5 years when a staging scan was indicated, and CT of the liver and/or brain in the presence of appropriate symptoms or laboratory values.
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PMID:Imaging techniques and guidelines for evaluation and follow-up of breast cancer patients. 355 14

The word mastectomy and its modifiers are used so loosely and have so many meanings in the literature that it is often difficult to determine precisely what procedure the authors are discussing. Simple descriptive terms should be used that would standardize the terminology with respect to operative techniques. The classical term radical mastectomy should be reserved to refer to a complete en bloc resection of the breast with the pectoralis major and minor muscles and the entire axillary contents, with or without a skin graft for wound closure. A total mastectomy should indicate a complete resection of the breast, including the fascia of the pectoralis major muscle. A local excision should be defined as a resection of the primary tumor with margins that are free of disease, with specific margins stated if desired. The axillary lymph node dissection should be defined according to the extent of the axillary contents excised.
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PMID:A mastectomy--how so? An etymologic plea. 395 70

A retrospective clinicopathologic review of 32 patients with mammary sarcoma exclusive of angiosarcoma or lymphoma was performed. For 25 patients with previously untreated lesions, the median tumor diameter was 4 cm and 14 patients had high or intermediate grade lesions. One of 22 patients treated by mastectomy and one of three patients treated by local excision died of sarcoma yielding an actuarial 5-year survival of 91%. None of the 25 patients had received adjuvant chemotherapy and only one treated by mastectomy had post-operative radiation therapy. Seven other patients were referred for treatment of recurrent mammary sarcoma. In this group, median size of the primary tumor was 6 cm and four had high or intermediate grade histology. Tumor control was achieved for only one of five patients with local recurrence and neither of the two with distant metastases. Median survival was 6 months following initiation of treatment for recurrence. Whenever possible breast sarcomas should be classified according to histologic cell type and grade. For lesions not readily classified, the terms unclassified or anaplastic sarcoma should be used. The diagnosis of stromal sarcoma is best reserved for those infrequent sarcomas that can be traced to the specialized periductal and perilobular stroma of the breast. Total mastectomy is recommended for most patients with postoperative radiation therapy indicated when the adequacy of the margin is in doubt. The role of adjuvant chemotherapy in the primary management of mammary sarcoma is yet to be determined.
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PMID:Sarcoma of the breast. A study of 32 patients with reappraisal of classification and therapy. 397 55


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