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

In 58 out of 515 patients with a primary carcinoma of the breast there was local-regional recurrence. Treatment consisted in generous excision and local radiation (50-60 Gy). After a mean observation period of 65.4 +/- 22.2 months, distant metastasization was found to have occurred in 22 patients (37.9%). Of the other 36 patients 23 (39.7%) had suffered no further recurrence at the end of this time, while 13 patients (22.4%) had a new local-regional recurrence. In a retrospective study a variety of parameters of prognosis were investigated in order to determine to their predictive value. It was found that there were significant differences in overall survival rates with tumors of histological differentiation stage I as compared to tumors of differentiation stages II and III (p = 0.003). There were no differences in the recurrence-free interval (p = 0.34). The presence or respectively lack of steroid receptors in the primary tumor made no significant differences to the recurrence-free interval and the survival rates. Those of the patients on whom this study was based whose axillary nodal status was N+ had received (adjuvant) treatment with cytostatics. This resulted in no differences in the recurrence-free interval (p = 0.28) or the overall survival rates (p = 0.3) when the N+ and N- patients were compared. The therapeutic conclusion drawn from these results is that breast carcinoma patients with an exclusively local-regional recurrence should initially receive local treatment only; systemic therapy should be reserved for the generalization stage.
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PMID:[Locoregional breast cancer recurrence. Treatment following exclusively local therapy]. 405 41

A series of 93 cases of endometrial adenocarcinoma stage I, of which 87 were treated by surgery in combination with pre- or postoperative irradiation, is analysed with respect to recurrence rate, survival and effect of preoperative irradiation on myometrial invasion. According to the authors, the treatment of choice remains a combination of surgery and radiation therapy in order to control the primary tumor and prevent vaginal recurrence. The authors recommend uterovaginal intracavitary irradiation followed by total abdominal hysterectomy and bilateral salpingo-oophorectomy with or without lymphadenectomy, and with adjunctive postoperative external irradiation reserved for the rare cases at high risk for locoregional failure (persistence of deep myometrial invasion, lymph node involvement).
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PMID:The role of radiation therapy in the treatment of adenocarcinoma of the corpus uteri stage I. A ten year experience (1970-1979). 609 40

The extreme radiosensitivity of testicular seminomas plus recent advances in chemotherapy for nonseminomatous tumors and for advanced seminomas have made long term survival possible in the large majority of patients with testis cancer. Since choice of therapy is determined by tumor histology and extent of disease, accurate clinical staging is critical. Computed tomography (CT) of the abdomen and chest is the imaging procedure of choice for staging testis cancer. Clinical staging accuracy of 80 to 90% can be achieved using CT in combination with radioimmunoassays for beta-HCG and AFP. Ultrasonography (US), while less sensitive and specific than CT for determining nodal status, may be useful in thin patients with sparse retroperitoneal fat; in addition US may play an important role in detecting occult testicular neoplasms and in assessing primary tumor extent within the scrotum. Lymphangiography should be reserved for Stage I patients in whom elective treatment of the retroperitoneum is not planned. Follow-up should include serial radioimmunoassays for serum AFP and beta-HCG and periodic CT examinations of the abdomen and chest. Technical improvements in CT scanners and further experience with the use of tumor markers should help refine our ability to stage and manage patients with testicular tumors. In addition, nuclear magnetic resonance (NMR) imaging and radionuclide imaging following injection of radioactively labelled antibodies to AFP and beta-HCG are new techniques which offer great promise for the future.
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PMID:Testicular tumors: oncologic imaging and diagnosis. 620 Apr 63

The results of treating anal canal carcinoma by radical external beam radiation alone (RT) or by combined 5-fluorouracil, mitomycin C and radiation (FUMIR), were compared in nonrandomized groups of patients treated in a single center. In each treatment regimen, surgery was reserved for those patients with residual carcinoma. The uncorrected 5-year survival rate in each group was approximately 70%, but primary tumor control was achieved in 93% (28/30) with FUMIR compared to 60% (15/25) treated with RT. Acute hematologic and enterocolic toxicity with uninterrupted external beam radiation courses of 5000 cGy in 4 weeks plus chemotherapy led to the adoption of split-course treatment. Serious late toxicity requiring surgical intervention occurred in 3 of 25 following RT, and in 5 of 30 following FUMIR. Colostomies were needed as part of treatment for residual carcinoma or for the management of treatment-related toxicity in 11 of 25 treated by RT and have been required to date in 4 of 30 treated by FUMIR. The improvement in the primary tumor control rate and the reduction in the number of patients requiring colostomy when compared with the results of RT favor combined chemotherapy and radiation as the initial treatment for anal canal carcinoma.
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PMID:Results and toxicity of the treatment of anal canal carcinoma by radiation therapy or radiation therapy and chemotherapy. 643 51

Eleven patients with extraskeletal Ewing's sarcoma (EES) were treated with combined modality therapy at the National Cancer Institute. The diagnosis of EES was reserved for lesions that were identical to Ewing's sarcoma of bone by light and electron microscopy. Diagnostic work-up to rule out a skeletal primary included bone scan, localized views of adjacent bone, and bone tomography. Seven patients presented with an extremity primary and four patients had a truncal primary. No patients had evidence of metastases at presentation. Patients were treated with combined modality therapy consisting of high-dose local irradiation and vincristine, actinomycin D, and cyclophosphamide chemotherapy following a biopsy or local excision. No attempt was made to excise widely the primary tumor mass. Gross tumors generally responded rapidly to the combined modality treatment. Of 11 patients, seven (64%) remain disease free, with a follow-up of three to seven years from completion of therapy. Long-term local control was established in nine of 11 patients (82%). Autopsy findings on two patients with local failure showed no tumor involvement of adjacent bone. Attempts at gross resections by radical surgical procedures do not routinely appear to be necessary in light of the high local control rates with high-dose irradiation.
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PMID:Extraskeletal Ewing's sarcoma: results of combined modality treatment. 1877 7

External beam megavoltage radiation therapy was used as primary treatment for 123 patients with rectal adenocarcinoma. Surgery was undertaken for some patients who had residual tumor. The overall five-year survival rate was 21 per cent. When patients were separated into those who presented with clinically mobile and those with clinically fixed rectal tumor masses, the survival rates were 38 per cent and 2 per cent, respectively. The primary tumor was controlled by radiation alone in 21 of 56 (38 per cent) patients who had mobile tumors but in only six of 67 (9 per cent) patients who had fixed tumors. Further investigation of high-dose primary radiation, with surgery reserved for patients with residual rectal carcinoma, may allow reduction of the number of patients who require abdominoperineal resection.
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PMID:Radical external beam radiation therapy for adenocarcinoma of the rectum. 682 58

A retrospective analysis was undertaken of 51 patients with primary anal canal carcinoma who were treated by radiation therapy, with surgery being reserved for those with residual carcinoma. The five-year uncorrected survival rate was 59 per cent, and the corrected survival rate was 71 per cent. The primary tumor was controlled by radiation alone in 29 of 51 patients (57 per cent) and by subsequent radical surgery in eight of ten patients. Abnormal lymph nodes were controlled by radiation alone in eight of 11 patients. Only three of 29 patients required surgery for complications associated with radiation in the absence of persistent tumor. Seventy-seven per cent (23 of 30) of long-term survivors did not require colostomy and retained anal continence. It is concluded that modern radiation therapy techniques are well tolerated and are an effective method of treating carcinoma of the anal canal.
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PMID:Primary radiation therapy in the treatment of anal canal carcinoma. 717 46

In this paper we present five new cases and review sixty-one reported cases of extra-osseous chondrosarcoma. The lesion has a predilection for middle-aged men and for localization in the extremities. The mild and delayed nature of the symptoms contributes to delayed or inadequate treatment and an unusually high over-all recurrence rate of 50 per cent. En bloc resection is the treatment of choice. Amputation should be reserved for large tumors with extensive or intra-articular invasion, osseous erosion, or major neurovascular involvement. Pulmonary lobectomy appears to be effective in treating localized pulmonary metastasis. Chemotherapy and radiotherapy can also provide palliative benefits to patients with widespread metastases. Nearly all (77.8 per cent) of the known disease-related fatalities took place during the first year after operation on the primary tumor. The over-all five-year survival rate most likely is less than 81.2 per cent.
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PMID:Extra-osseous chondrosarcoma. Report of five cases and review of the literature. 735 50

Our purpose was to study the incidence, severity, timing, clinical management, and outcome for patients who developed hemorrhagic cystitis following pelvic radiotherapy for stage Ib cancer of the cervix. A total of 1784 patients with stage Ib cancer of the cervix were treated with pelvic radiotherapy at the University of Texas M. D. Anderson Cancer Center between 1960 and 1989. The majority received a combination of external-beam and intracavitary treatments. Patients with hemorrhagic cystitis were identified through retrospective review of their medical records, and a grade was assigned to each occurrence. A total of 116 (6.5%) patients with hemorrhagic cystitis were identified. The initial occurrence was grade 1 (minor occurrence) in 59%, grade 2 (repeated minor bleeding) in 23%, and grade 3 (hospitalization for medical management) in 18%. The median interval from the beginning of radiotherapy to the onset of hematuria was 35.5 months (mean 58 months). The median time to initial grade 3 occurrences was 37.5 months (mean 84 months). Actuarial life table analysis revealed that the risk of hematuria is 5.8% at 5 years, 7.4% at 10 years, and 9.6% at 20 years. The risk for a grade 3, 4 (requiring surgical intervention), or 5 (death) complication is 1.0, 1.4 and 2.3% at 5, 10, and 20 years, respectively. Approximately one-third of the patients with a grade 3 occurrence were rehospitalized for management of bladder complications a median of 3.5 months following the first grade 3 occurrence, although some of these readmissions occurred many years later. Associated urinary-tract infection was common. In no case did a cystoscopic bladder biopsy reveal recurrent tumor or a second primary tumor when visual inspection revealed typical radiation changes. The incidence of severe hemorrhagic cystitis following radiation for stage Ib cancer of the cervix is low and can occur many years following treatment. Minor episodes of hematuria are managed by empiric antibiotic therapy until the results of urine cultures are available. Cystoscopy is reserved for patients with persistent bleeding to rule out clot retention or the slight possibility of a second primary tumor or recurrent disease. Biopsy should be avoided if obvious radiation changes are present. Clot evacuation and continuous bladder irrigation remain the standard treatment for patients with heavy bleeding.
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PMID:Hemorrhagic cystitis following radiotherapy for stage Ib cancer of the cervix. 795 85

The records of 130 consecutive patients undergoing marginal or segmental mandibulectomy for squamous cell carcinoma of the oral cavity or oropharynx were reviewed. An attempt was made to correlate incidence of recurrence with characteristics of the primary tumor and extent of mandibulectomy. The local recurrence rate was 19% following marginal mandibulectomy and 6% following segmental mandibulectomy. The incidence of local recurrence was independent of the size of the primary tumor or the extent of lymph node metastases. Neither mandibular invasion by tumor nor the addition of radiotherapy influenced local recurrence. Ten of 15 patients recurring locally after marginal mandibulectomy were salvaged by further surgery. This study suggests that local control following marginal mandibulectomy is comparable to that following segmental mandibulectomy regardless of the size of the tumor. Segmental mandibulectomy should be reserved for those tumors invading deeply into the mandible or wrapping around it.
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PMID:Local control of squamous cell carcinoma following marginal and segmental mandibulectomy. 841 53


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