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11.
Summary
Malignant lymphomas can be subdivided into Hodgkin's disease and low- or high-grade non-Hodgkin's lymphoma (NHL). The principal
therapeutic options are polychemotherapy and radiotherapy. Besides the histological classification, staging of the disease
with particular regard to risk factors is an essential prerequisite for the therapeutic decision. Diagnostic imaging modalities
such as computer tomography, magnetic resonance imaging, and ultrasonography have improved the accuracy of clinical staging
such that invasive pathological staging is only necessary in exceptional cases. A novel therapeutic approach is high-dose
chemotherapy with autologous haematopoietic stem-cell support. This treatment improves the survival of patients with relapsed
high-grade NHL. The place of high-dose therapy as the primary therapeutic option in malignant lymphoma is now being assessed
in prospective studies following encouraging results from single-centre studies, including those involving the treatment of
low-grade lymphoma. The effects of antibodies directed against lymphatic cells are currently being examined in experimental
treatments. An assessment of the viability and rate of proliferation of lymphoma tissue on completion of therapy using sensitive
radiological and nuclear medical methods is an important aim for the future.
Eingegangen am 5. November 1996 Angenommen am 12. November 1996 相似文献
12.
M. Burdelski M. Oellerich J. Düwel H. Raith M. Scheruhn B. Ringe B. Rodeck A. Latta R. Pichlmayr J. Brodehl 《European journal of pediatrics》1992,151(Z1):S39-S43
The pre-operative risk of paediatric liver transplantation candidates (n=41) was assessed in a prospective study by means of clinical symptoms, conventional static and liver blood flow dependent dynamic liver function tests. Nine patients died during the 365-day waiting period. The data were subjected as covariates to a survival analysis in the Cox proportional hazards model. There was a significant relationsship between the results of mono-ethylglycinexylidide (MEGX) formation and ICG test and the 365-day survival rate. In the stepwise analysis, none of the remaining parameters improved the predictive ability when added to the dynamic liver function test results. The assessment of post-transplantation liver function was studied in 27 patients during the first 28 postoperative-day period. In addition, liver function was studied in a cross-sectional study 1–7 years after successful liver transplantation in children with complete or partial rehabilitation. In the early postoperative period severe organ damage was indicated by both static and dynamic liver function tests. In the later course after transplantation no deterioration of liver function measured with MEGX formation was to be observed. These findings demonstrate the usefulness of dynamic liver function tests in the pre- and post-transplant assessment of liver function. 相似文献
13.
M. Peiper D. Zurakowski C. Zornig 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1995,380(6):333-339
Soft tissue sarcomas (STS) tend to recur locally. In a series of 140 patients operated on during the past two decades with STS of the extremities and trunk, prognostic factors influencing local recurrence were determined. Statistical significance was evaluated for the quality of surgical resection (P<0.001), regional positive lymph nodes (P=0.03), and adjuvant radiotherapy (P=0.01) [for resection without wide margins (R1) and low-grade (G3) tumors]. In 1988, the surgical procedure was standardized. After 1987, local recurrence decreased significantly (P < 0.001). In subfascial tumors, local recurrence occurred far less in cases of compartmental resection than with wide excision. These data indicate that the course of patients with STS can be beneficially influenced by optimal therapy. Resection with wide margins in all three dimensions is the aim of sarcoma surgery. Postoperative radiation therapy is indicated in the case of R1 resection.
Lokalrezidive von Weichteilsarkomen an Extremitäten und Rumpf
Zusammenfassung Weichteilsarkome neigen zur Ausbildung von Lokalrezidiven. In einer Studie von 140 Patienten der letzten 20 Jahre mit Sarkomen an Extremitäten und Rumpf wurde untersucht, welche Faktoren das Auftreten von Lokalrezidiven beeinflussen. Statistische Signifikanz ergab sick fur die Qualität der chirurgischen Re sektion (R) (p<0,001), den regionalen Lymphknotenstatus (p=0,03) sowie eine adjuvante Strahlentherapie (p=0,01) [bei marginal resezierten (RI), niedrig differenzierten (G3) Tumoren]. 1988 wurde das chirurgische Vorgehen standardisiert. In der Zeit danach traten signifikant weniger Rezidive auf als davor (p < 0,001). Bei subfaszialer Lage traten Rezidive nach Kompartmentresektion wesentlich seltener auf als nach weiter Resektion. Der Krankheitsverlauf von Weichteilsarkomen ist also durchaus therapeutisch beeinflußbar. Ein dreidimensional weiter Sicherheitsabstand ist das entscheidende Therapieziel, eine Bestrahlung in R1-Situationen indiziert.相似文献
14.
Abhishek Srivastava Anirban Ghosh Somnath Saha V. P. Saha Debdulal Chakraborty 《Indian journal of otolaryngology and head and neck surgery》2007,59(4):322-326
38 cases of sarcoma of head and neck region were analysed in a retrospective way in relation to age, anatomic location, histological,
clinical profile, and surgical approaches. Compared to other types of head and neck neoplasms, such as squamous cell carcinoma,
soft tissue sarcomas have low rates of regional metastases. However the biological behaviour of soft tissue sarcoma is more
aggressive specially in paediatric age group. In the present series, CT scan was considered as the primary modality of investigation.
Surgery generally has been recommended as the primary method of treatment for achieving local control, except in those high-grade
tumours arising in sites not amenable to resection. 3-year and 5-year survival rates in this present series 50% and 31.6%
respectively. 相似文献
15.
Dr. Harvey I. Pass MD Karen Kranda RN Barbara K. Temeck MD Irwin Feuerstein MD Seth M. Steinberg PhD 《Annals of surgical oncology》1997,4(3):215-222
Background: We analyzed morbidity and mortality, sites of recurrence, and possible prognostic factors in 95 (78 male, 17 female) patients
with MPM on phase I–III trials since 1990. A debulking resection to a requisite, residual tumor thickness of ≤ 5 mm was required
for inclusion.
Methods: Preoperative tumor volumes were determined by three-dimensional reconstruction of chest computerized tomograms. Pleurectomy
(n=39) or extrapleural pneumonectomy (EPP; n=39) was performed. Seventeen patients could not be debulked. Preoperative EPP
platelet counts (404,000) and mean tumor volume (491 cm3) were greater than that seen for pleurectomy (344,000, 114 cm3).
Results: Median survival for all patients was 11.2 months, with that for pleurectomy 14.5 months, that for EPP 9.4 months, and that
for unresectable patients 5.0 months. Arrhythmia (n=14; 15%) was the most common complication, and there were two deaths related
to surgery (2.0%). Tumor volume of >100 ml, biphasic histology, male sex, and elevated platelet count were associated with
decreased survival (p<0.05). Both EPP and pleurectomy had equivalent recurrence rates (27 of 39 [69%] and 31 of 39 [79%],
respectively); however, 17 of 27 EPP recurrences as opposed to 28 of 31 pleurectomy recurrences were locoregional (p2=0.013).
Conclusions: Debulking resections for MPM can be performed with low operative mortality. Size and platelet count are important preoperative
prognostic parameters for MPM. Patients with poor prognostic indicators should probably enter nonsurgical, innovative trials
where toxicity or response to therapy can be evaluated.
Presented at the 49th Annual Cancer Symposium of The Society of Surgical Oncology, Atlanta, Georgia, March 21–24, 1996. 相似文献
16.
急性重症胆管炎的预后因素分析 总被引:1,自引:0,他引:1
目的分析急性重症胆管炎(ACST)的预后因素,探讨合理的治疗方案。方法对168例ACST病人的临床资料进行回顾性分析,采用卡方(χ2)检验进行统计处理。结果影响ACST的预后因素有年龄、入院时休克与否、是否合并器官功能障碍综合征(MODS)、治疗方式及手术时机,而既往有无胆管炎发作史与预后无明显相关。结论针对影响预后的因素,及时采取手术干预,可提高治疗效果、降低病死率。 相似文献
17.
18.
E. Windler U. Ewers-Grabowl J. Thiery A. Walli D. Seidel H. Greten 《Journal of molecular medicine (Berlin, Germany)》1994,72(12):939-943
Clinical observations show that severe illness often leads to hypocholesterolemia. To verify this finding and to define the relationship between serum cholesterol and a patient's prognosis, a study was conducted in two large hospital populations. Of 24,000 and 61,463 adult patients (populations I and II) an average of 3.8% and 3.6% died in hospital, respectively. The mean serum cholesterol levels of patients who died was significantly lower than that of those who survived (163.6 mg/dl versus 217.8 mg/dl;P < 0.0001). The average cholesterol of surviving patients was similar to that of 6,543 healthy controls. During hospitalization serum cholesterol levels of 100 mg/dl were encountered in 1.2% and 3.6% of patients of populations I and II, respectively. The mortality of these hypocholesterolemic patients was about tenfold higher than average and showed a strong, inverse, linear relationship with serum cholesterol concentrations. Patients whose serum cholesterol level dropped to less than 45 mg/dl did not survive. These data show that in severely ill patients serum cholesterol may decline to very low concentrations, and the prognosis is reflected by the degree of hypocholesterolemia, which thus may serve as a clinically useful prognostic parameter.
Correspondence to: E. Windler 相似文献
19.
20.
Relationship between the expression of various markers and prognostic factors in breast cancer 总被引:5,自引:0,他引:5
Anim JT John B Abdulsathar S SA Prasad A Saji T Akhtar N Ali V Al-Saleh M 《Acta histochemica》2005,107(2):87-93
The immunohistochemical detection of six markers of breast cancer has been compared in the present study with known prognostic factors of the disease to establish locally a standard panel of markers for the management of breast cancer. Sections of tissue of 114 consecutive breast cancer cases were studied immunohistochemically, using antibodies against oestrogen receptor (ER), progesterone receptor (PR), androgen receptor, c-erbB2, cathepsin D, and cyclin D. Marker labelling was graded as recommended in the literature. Using the chi(2)-test, relationships were determined between marker labelling and histological type of cancer, tumour grade, tumour size, axillary lymph node status and age of patient. A p value below 0.05 was considered significant. A positive relationship was found between ER and PR and lower grades of cancer, and a negative relationship was found with medullary and atypical medullary carcinoma. The four other markers showed no relationship with grade or type of cancer. All markers showed no significant relationship with size of tumour, presence of axillary node metastasis or age of patient. There was positive correlation between c-erbB2 and cathepsin D. Our study confirms the association between ER and PR and histological type and grade of breast cancer, both known parameters of good prognosis. We found no consistent relationship between the other four markers and prognostic factors studied, other than the suggestion that c-erbB2 and cathepsin D may be useful markers for poor prognosis and can be usefully applied locally, especially in the light of the current availability of trastuzumab (Herceptin) for management of c-erbB2-positive cases. We found no relationship between the markers and tumour size, axillary lymph node status or age. 相似文献