International advances in surgical oncology最新文献

With 612 cases of malignant thyroid tumor, the follow-up observations were conducted from 7 to 11 years after initial examination, and 512 cases were follow up. It was found that 46 cases died of the primary cancer, while 13 died of other causes. The prognosis proved to be favorable with adenocarcinoma but with anaplastic carcinoma or squamous cell carcinoma the disease proved to be ultimately fatal. The survival rates 5 and 10 years after diagnosis were 97.4% and 95.8% for papillary adenocarcinoma, 95.6% and 92.5% for follicular adenocarcinoma, 7.7% and 7.7% for anaplastic carcinoma, 0% for squamous cell carcinoma, and 66.9% and 66.9% for malignant lymphoma. As to the causes of death, the obstruction due to the neck tumor ranks first, indicating that respiratory deaths are numerous. However, as there are histologically many deaths due to the transformation from adenocarcinoma to squamous cell carcinoma or anaplastic carcinoma, it is desirable to perform radical surgery at an early stage.

Breast reconstruction after mastectomy is discussed with emphasis on present surgical techniques and results achieved. The deformity is defined and the goals outlined. Contra-indications, indications, evaluation of the patient and proper choice of reconstructive procedures and implantable materials are reviewed as well as complications and restrictions. Selective illustrations demonstrate some of the clinical experience of patients treated at Memorial-Sloan Kettering Cancer Center.

This chapter presents an overview of the current concepts in the diagnosis and treatment of carcinoma of the lung. Emphasis is placed on the increasing incidence, methods of detection, and diagnosis, and on the importance of staging before treatment. Best treatment recommendations are detailed by stage of disease and by presentation, with supporting evidence from institutional experience and the literature. Although surgical treatment is emphasized, other forms of management appropriate to the stage of the disease are included. The use of intraoperative irradiation to supplement surgery in the control of localized lung carcinoma is also described.

Thyroid cancer is not a common cancer and consists of a variety of tumors with different biological characteristics. Diagnosis and therapeutic approaches differ considerably, depending on which subgroup the tumor belongs to. Differentiated carcinomas, which constitute the bulk of thyroid carcinoma, often retain the features of the thyroid gland, which can be taken advantage of in their management. The prognosis of these patients is usually excellent. Undifferentiated carcinoma, in contrast, is an aggressive tumor and usually is fatal within a year from the diagnosis. Therefore, an aggressive therapeutic approach is required. Transformation of differentiated carcinoma to undifferentiated carcinoma does occur, although infrequently. The importance of proper management of patients with differentiated carcinoma is obvious. Medullary carcinoma, which originates from the parafollicular cells, has various interesting biological characteristics and is a medium-grade malignancy.

Clinicopathological features of 405 patients with esophageal tumors other than squamous cell carcinoma, which were resected surgically at 68 institutions in Japan, were analyzed and compared with those of 4,995 cases of esophageal malignant neoplasms autopsied during 19 years (1958-1976) in Japan. Of 405 surgical cases, 149 were benign tumors, most of which (89%) were leiomyomas. The incidence of malignant tumors other than squamous cell carcinoma was 2.1% in the surgical, and 7.2% in the autopsied cases of esophageal cancer. Malignancies were classified into 15 histologic types. Most of them did not differ in sex and age incidence or location of the primary site from squamous cell carcinoma, except for adenocarcinomas, in which there was a greater incidence of occurrence in the lower portion of the esophagus. Carcinosarcomas and pseudosarcomas showed peculiar clinical and pathological characteristics. Overall prognosis was poor except in cases of pseudosarcoma and leiomyosarcoma.

In a few short years, computed tomography has become an important diagnostic procedure in the examination of the abdomen and pelvis. Its forte lies in its ability to provide cross-sectional views of excellent anatomical detail. Imaging of deep-seated structures such as the pancreas, adrenal glands, and enlarged retroperitoneal lymph nodes is now possible. The ability to distinguish small variations in tissue density enables the radiologist to evaluate the texture of solid structures, and to differentiate them from cysts or abscesses. The addition of contrast enhancement makes it possible to determine the vascularity of a lesson. The major limitation of CT is poorer delineation of structures in thin patients, and in patients in whom voluntary and involuntary motion cannot be interrupted. Computed tomography is compared with other complementary imaging procedures to include sonography, radionuclide imaging, and conventional radiograph procedures. It has replaced invasive diagnostic procedures in many instances. In a given situation, one or more imaging modalities may be appropriate.