Search Results - (Author, Cooperation:Teleky)

1749-6632

Blackwell Publishing Journal Backfiles 1879-2005

Natural Sciences in General

Electronic Resource

0019-1035

Elsevier Journal Backfiles on ScienceDirect 1907 - 2002

Physics

Electronic Resource

0040-5809

Elsevier Journal Backfiles on ScienceDirect 1907 - 2002

Biology

Electronic Resource

1530-0358

Rectal cancer ; Sacrum resection ; Morbidity ; Survival ; Recurrence ; Surgery

Springer Online Journal Archives 1860-2000

Medicine

Abstract PURPOSE: Resection of the sacrum is the only curative therapy of isolated sacral recurrence after primarily resected rectal cancer. The aim of the study was to assess whether there is a benefit in terms of overall survival, morbidity, and mortality when sacrum resection is performed more radically and in cooperation between colorectal and orthopedic surgeons. Possible prognostic factors were also assessed. METHODS: Twelve consecutive patients who underwent interdisciplinary partial sacral resection were included in a retrospective cohort study. Furthermore, overall survival rate and survival time were calculated. RESULTS: Histologic examination showed tumor-free resection margins in all cases. Extended resection was necessary in seven patients, including total pelvic exenteration in two. No perioperative death occurred and no patient required early reoperation. Complications were observed in 42 percent of patients, mainly caused by poor wound healing. All patients experienced relief from pain. One-year and three-year overall survival rates were 50 and 17 percent, respectively. The overall mean survival time was 21.7 months. Patients who died of recurrent disease within one year either underwent former resection for locoregional recurrence, had extensive local recurrent tumors affecting pelvic visceral structures, or retrospectively suffered from metastatic sacral tumor manifestation. CONCLUSION: The mortality and morbidity rates observed in the present study seem to justify partial sacral resection as a means to achieve palliation of perineosacral pain in spite of rare overall long-term survival.

Electronic Resource

1437-1596

Springer Online Journal Archives 1860-2000

Medicine

Law

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1437-1596

Springer Online Journal Archives 1860-2000

Medicine

Law

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1437-1596

Springer Online Journal Archives 1860-2000

Medicine

Law

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1437-1596

Springer Online Journal Archives 1860-2000

Medicine

Law

Electronic Resource

1432-2323

Springer Online Journal Archives 1860-2000

Medicine

Abstract. Although malignant behavior of rectal carcinoid tumors is rare, the risk of metastases and death does exist. Adaptation of therapy according to the estimated malignancy seems necessary. To develop a stage-dependent therapy, 31 patients with rectal carcinoid tumors measuring 5 to 50 mm in diameter were analyzed retrospectively. Malignancy was estimated according to tumor size, infiltration depth, and histopathology. There were 18 tumors within the mucosa and submucosa (T1), 7 tumors with muscularis propria invasion (T2), and carcinoid tumor penetrating the full rectal wall (T3) or spreading to surrounding tissue (T4) in 6 patients. Altogether 20 patients (65%) were treated with a minimally invasive intervention: endoscopic polypectomy (EP) in 12 and transanal excision (TE) in 8 patients. In 11 patients (35%) aggressive surgical procedures—anterior resection (AR) in 4 and abdominoperineal resection (APR) in 7—were performed. After a mean ± SD follow-up of 86.0 ± 61.3 months, tumor recurrence was not seen in any of the 20 patients with minimally invasive treatment, and all were still alive. No severe complications associated with surgical procedures were detected. In contrast, 5 of the 10 patients with advanced tumor stage died from their disease despite aggressive surgery (AR, APR). In conclusion, depending on tumor stage, treatment of rectal carcinoids includes EP, TE, or extended resection. Minimally invasive techniques are safe treatments for small to medium-size T1/T2 rectal carcinoids. Extended surgery cannot improve the overall survival of those with advanced tumors (T3/T4, N1, M1) but can be beneficial for preventing local complications.

Electronic Resource

1432-2323

Springer Online Journal Archives 1860-2000

Medicine

Résumé On a analysé les dossiers de 169 hommes traités pour un cancer du sein dans 36 centres chirurgicaux en Autriche entre 1970 et 1991. Les données cliniques ont été analysés et des facteurs pronostiques établis. Après une période d'observation médiane de 51 mois, 60 patients (35%) avaient une récidive. La survie à 5 ans sans maladie a été évaluée à 55% pour le groupe entier, alors que la survie à 5 ans globale a été de 62%. Lorsqu'on a comparé ces cas à des cancers de sein chez la femme, on s'est rendu compte que l'évolution dans cette série était peut-être en rapport avec un nombre plus important de stades avancés de patients avec cancer. On a démontré que la taille de la tumeur (survie sans récidive; p =0.0001; survie globale p=0.03) et l'état des ganglions axillaires (survie sans récidive p=0,00001, survie globale p=0,0001) avaient une valeur pronostique. En analyse multifactorielle, l'état ganglionnaire axillaire était toujours considéré comme facteur pronostique (survie sans récidive p=0.0001; survie globale p=0.01). Les interventions locales n'avaient aucune influence pronostique sur les récidives locales.

Resumen Se recolectaron datos en 169 hombres tratados por cáncer mamario en 16 departamentos quirúrgicos de Austria en el período 1970 a 1991. En el presente estudio reportamos diferentes características clínicas y tratamos de definir la importancia de factores establecidos de pronóstico. Luego de un período promedio de observación de 51 meses, se observó recurrencia en 60 pacientes (35%). La tasa estimada de sobrevida libre de enfermedad recurrente para la totalidad del grupo fue 55% y la tasa estimada de sobrevida global a 5 años fue 62%. En tanto que la estadificación de los datos es comparable a la de las mujeres con cáncer mamario, el resultado final en esta serie puede ser atribuido a una frecuencia relativamente alta de tumor en estados avanzados. El tamaño del tumor (sobrevida libre de recurrencia p=0.0001; sobrevida global p=0.03) y estado de los ganglios axilares (sobrevida libre de recurrencia p=0.00001; sobrevida global p=0.0001) demostró tener impacto en cuanto al pronós neo. En el análisis multivariable, el estado de los ganglios linfáticos axilares (sobrevida libre de recurrencia p=0.0001; sobrevida global p=0.01) retuvo su influencia pronóstica. Los diferentes procedimientos operatorios de tratamiento local no demostraron efecto en cuanto a la recurrencia local.

Abstract Data were collected on 169 men treated for breast cancer at 36 surgical departments in Austria between 1970 and 1991. We report here several of their clinical features and assess the importance of established prognostic factors. After a median observation period of 51 months 60 patients (35%) suffered a recurrence. The estimated 5-year recurrence-free survival for the entire group was 55%, and the estimated 5-year overall survival was 62%. Although stage-adjusted data are comparable to those for female breast cancer, the outcome in this series may be attributed to a relatively high frequency of advanced tumor stages. Tumor size (recurrence-free survival p=0.00001; overall survival p=0.03) and axillary lymph node status (recurrence-free survival p=0.0001; overall survival p=0.0001) proved to have a prognostic impact. Using a multivariate analysis, axillary lymph node status (recurrence-free survival p=0.001; overall survival p=0.01) still had prognostic influence. The various procedures used had no effect on local recurrence.

Electronic Resource

1432-2307

Keywords Colorectal carcinoma ; p53 ; mdm2 ; p21Waf1/Cip1 ; SSCP

Springer Online Journal Archives 1860-2000

Medicine

Abstract  Abrogation of the normal p53 pathway is the most common molecular alteration in human cancer. p53 Gene status can be potentially assessed through the expression of proteins known to be activated by the wild-type p53 (wt p53) system, such as mdm2 and p21Waf1/Cip1. In this study, the frequency of mdm2, p21Waf1/Cip1, and p53 protein expression was investigated using immunohistochemistry (IHC) in 88 colorectal carcinomas (CRCs). The relationship between these expressions and p53 status was examined. p53 status and the immunophenotypes characterizing these tumors were correlated with standard prognostic variables. Mutation of p53 was detected using single-strand conformational polymorphism (SSCP) analysis and sequencing. Concordance between p53 gene status and p53 immunoreactivity was seen in 62 of 88 (70.45%) carcinomas. Mdm2 expression was found in 22 of 45 (48.88%) and 5 of 43 (11.62%) of the tumors with wt p53 and mutated p53 (P〈0.0001), respectively. Predominantly, higher p21Waf1/Cip1 expression was associated with wt p53 (P〈0.001). All wt p53 cases that expressed mdm2 also expressed p21Waf1/Cip1. These results suggest that there is a subgroup of CRCs in which p53 is functionally active, inducing transcription of mdm2 and Waf1/Cip1. Their combined evaluation may provide important clues for planning adjuvant systemic therapy and gene therapy based on the restitution of p53 function. However, no significant association was found between the immunophenotypes and the standard prognostic variables investigated.

Electronic Resource

1437-1596

Springer Online Journal Archives 1860-2000

Medicine

Law

Electronic Resource

1437-1596

Springer Online Journal Archives 1860-2000

Medicine

Law

Electronic Resource

1437-1596

Springer Online Journal Archives 1860-2000

Medicine

Law

Electronic Resource

1437-1596

Springer Online Journal Archives 1860-2000

Medicine

Law

Electronic Resource

1437-1596

Springer Online Journal Archives 1860-2000

Medicine

Law

Electronic Resource

1437-1596

Springer Online Journal Archives 1860-2000

Medicine

Law

Electronic Resource

1437-1596

Springer Online Journal Archives 1860-2000

Medicine

Law

Electronic Resource

1437-1596

Springer Online Journal Archives 1860-2000

Medicine

Law

Electronic Resource

1437-1596

Springer Online Journal Archives 1860-2000

Medicine

Law

Electronic Resource