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Caliskan M Gatti G Sosnovskikh I Rotmensz N Botteri E Musmeci S Rosali dos Santos G Viale G Luini A 《Breast cancer research and treatment》2008,112(3):513-521
Background Paget’s disease of the breast is an uncommon presentation of breast malignancy, accounting for 1–3% of all the breast tumors
and presents in different histopathologic patterns: in association with an underlying invasive or non invasive carcinoma,
or without any underlying neoplasia. In the literature, different methods are used for the treatment. Mastectomy with or without
axillary dissection has been considered as the standard treatment procedure for many years. Several studies have already shown
that breast conservation with radiation therapy is an oncologically safe option. Regarding the axillary approach, several
studies have documented the presence of positive sentinel lymph node even in Paget’s disease alone. The objective of this
study was to retrospectively analyze outcome of patients affected by Paget’s breast disease and to define our institutional
experience. Patients and methods Between May 1996 and February 2003, 114 patients with confirmed Paget’s disease of the breast were retrieved and underwent
surgery at the European Institute of Oncology of Milan, Italy. The median age of the patients was 54 years at the time of
the diagnosis. In our study, the histopathological examination of the operated specimen revealed one hundred seven patients
with Paget’s disease associated with an underlying invasive or non invasive carcinoma, and seven patients without underlying
carcinoma. Patients underwent either conservative breast surgery or mastectomy, with or without sentinel lymph node biopsy
and/or axillary surgery. Each patient was evaluated after surgery at a multidisciplinary meeting to selecting systemic therapy.
Results Seven patients had “pure” Paget’s disease of the breast and one hundred seven had the disease associated with an underlying
carcinoma. As surgical techniques 71 mastectomies and 43 breast conserving surgeries have been performed. Complete axillary
dissection was done in patients with clinically positive lymph node and/or sentinel lymph node biopsy positive. Sentinel lymph
node biopsy was performed in nineteen patients with invasive component and five were positive and underwent axillary dissection.
Eleven sentinel lymph node biopsies were done in patients with non invasive component and none of them was positive. Adjuvant
systemic therapies were based on the final tumor, node and metastasis stage: thirty patients received adjuvant chemotherapy
alone, fourteen received endocrine treatment alone, twenty-six patients were evaluated to receive both chemo and endocrine
therapy. The median duration of follow up was 73 months and was updated in the last 6 months. Five patients developed local
recurrence, one had regional recurrence, another two had loco-regional recurrences and fourteen had distant metastasis as
a first event. Malignancy-related deaths were censored in the statistical analyses cancer for and due to another tumor in
eleven patients. Additionally, deaths were not related to malignancy totally in thirteen patients. Conclusions Screening examination and imaging techniques are fundamental. Breast conserving surgery combined with breast irradiation
for patients with invasive and non invasive breast carcinoma has become the treatment of first choice. All surgical conservative
approaches should include the complete nipple–areolar complex and margins of resected specimen free of tumor. Thanks to the
evolution of the conservative approach, good cosmetic result can be obtained. To be informed about the axillary lymph node
status and to avoid the patient to have a second surgical approach, sentinel lymph node biopsy should be performed. 相似文献
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Gemechu Shimelis Dejene van Vliet Christine M. Win Aung Ko Figueiredo Jane C. Le Marchand Loic Gallinger Steven Newcomb Polly A. Hopper John L. Lindor Noralane M. Jenkins Mark A. Dowty James G. 《Familial cancer》2020,19(3):215-222
Familial Cancer - Individuals who carry pathogenic mutations in DNA mismatch repair (MMR) genes have high risks of cancer, and small studies have suggested that these risks depend on the sex of the... 相似文献
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Setsuo Takeda Konstanty Wierzba Jun-ichi Yamashita Hiroshi Matsumoto Hiroyasu Satake Yuji Yamada Norio Unemi Yusuke Wataya Hikoya Hayatsu 《Cancer chemotherapy and pharmacology》1992,30(5):360-364
Summary 5-Trifluoromethyl-2-deoxyuridine (CF3dUrd), an antitumor agent, is known to be short-lived in human plasma. Since its rapid elimination from the blood-stream seems to have descouraged the clinical evaluation of this drug, we explored the potential use of masked derivatives of CF3dUrd as depot forms of the parent compound. First, we observed that the toxicity of CF3dUrd against HeLA cells in culture was 104 times greater for a 24-h treatment as compared with a 1-h treatment at identical concentrations of the drug, which suggests the importance of using a prolonged treatment period. In fact, the divided dosing of CF3dUrd to L1210-bearing mice was markedly more effective than its single administration. 5-O-Hexanoyl-,N
3-p-butylbenzoyl-, 5-O-benzyloxymethyl-, and 3-O-benzyl-CF3dUrd were found to be effective in maitaining the CF3dUrd concentration in plasma. The oral doses of these agents required to achieve 50% growth inhibition (ED50) in mice bearing sarcoma 180 tumors were 19, 34, 10, and 13 mg kg–1 day–1, respectively, whereas that of CF3dUrd was 63 mg kg–1 day–1. The ED50 values for these compounds were inversely correlated with the residence time of CF3dUrd in plasma. The therapeutic indices of these compounds, calculated as the dose producing a 50% inhibition of body-weight gain (IB50) divided by the ED50 value (1.89, 1,21, 1.40, and 2.15, respectively), were significantly higher than that of CF3dUrd (0.78). Consequently, these depot forms of CF3dUrd, particularly 3-O-benzyl-CF3dUrd, are expected to be more useful than the parent compound as antitumor agents.Abbreviations CF3dUrd
5-trifluoromethyl-2-deoxyuridine
- CF3dUMP
5-trifluoromethyl-2-deoxyuridine-5-monophospate
- S180
sarcoma 180
- L1210
L1210 leukemia
- kel
elimination rate constant
- T1/2
half-life time
- AUC
area under the curve
- ILS
increase in life span
- TS
thymidylade synthase
- FdUMP
5-fluoro-2-deoxyuridine-5 monophosphate
- FUra
5-fluorouracil 相似文献
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Chabner BA 《The oncologist》2008,13(3):212-213
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W.Schrder 《中国肿瘤临床(英文版)》2004,(4)
IntroductionThe standard reconstruction after esophagectomy isthe formation of a gastric tube with cervical or intratho-racic esophagogastrostomy.This type of reconstructionis associated with a considerable morbidity and mortal-ity due to anastomotic leakage of the esophagogastrosto-my.Although several etiological factors have beendiscussed to contribute to this clinically relevant com- 相似文献
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Xijiang Zhao Jingtao Huang Peng Tang Peng Ren 《中国肿瘤临床(英文版)》2007,4(2):109-114
OBJECTIVE:To determine the value of resection of combined visceral organs in surgical treatment of gastric cardiac carcinoma. METHODS:We retrospectively analyzed 217 random patients with car- cinoma of the gastric cardia who underwent a gastric cardiac resection.The patients had been treated as fol ows:186 with partial gastrectomy,31 with total gastrectomy,97 with a combined-visceral resection,of which 82 under- went a splenectomy plus partial pancreatectomy,10 with splenectomy alone and 5 with partial hepatectomy and diaphragmatectomy. RESULTS:The total patients were divided into 3 groups:128 with a gas- trectomy alone,10 with gastrectomy and splenectomy,and 82 with gastrec- tomy and splenectomy plus pancreatectomy.The operating times for these 3 groups were respectively 3.0 h,3.1 h and 3.8 h.The hospitalization times were respectively 23.8 d,31.2 d and 25.9 d.No differences in post-operative complications were found between these 3 groups.There were 92 patients who underwent a gastrectomy combined with a splenectomy and(or)the pancreatectomy,in which 92 No.10 lymph nodes were eliminated,with an average of one in each patient.Among the 125 patients not receiving a sple- nectomy but with elimination of lymph nodes,82 underwent a gastrectomy combined with partial pancreatectomy,of which 107 lymph nodes were elimi- nated for the No.11 group,with an average of 1.3 in each patient.There was a statisticaly significant difference between the 2 groups.The overal survival rates were similar in the 3 groups showing no statistical differences, but was higher in the Stage III patients with a combined resection of multi- organs.For patients in the Stage IV without resection of multi-organs,the survival rate was higher,but there was no significant difference between the 2 groups. CONCLUSION:It is difficult to determine precisely the involvement of para-tumorous organs with the eye during an operation.Combining a sple- nectomy with a pancreatectomy does not increase the post-operative compli- cations following surgical treatment for carcinoma of the gastric cardia.The combination of a splenectomy and partial pancreatectomy results in a higher survival rate and has an important significance for eliminating the lymph nodes of group 10 and 11,especially for patients in Stage III.In the applica- tion of a resection combining multi-organs,the doctor should make every effort to decrease the trauma and the complications based on the condition that the cancerous tissue is totally resected. 相似文献
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Yong Li Ming Gao Yang Yu Yigong Li Yan Zhang Xiaolong Li 《中国肿瘤临床(英文版)》2007,4(3):172-178
OBJECTIVE To systematically analyze and summarize non-thyroge-nous masses of the neck(NTMN)by consideration of new areas,a large sample size and multiple-aspect analysis.METHODS Our research involved 3,125 NTMN cases.We summarized the proportion of various NTMN and the distribution of the neck diseases based on the new international classification.The clinical traits such as sexual proportion and age,etc,were analyzed along with the unknown pri-mary cervical metastatic carcinomas(UPCMC),multiple nodular NTMN and tubercular lymphadenitis.RESULTS There were 68 different diseases identified.Among all the NTMN,the percentage of metastatic carcinomas was 63.3%.The neck masses with a focus above the clavicle comprised 62.3% of the metastatic carcinomas whose focuses were clear.Moreover,other results almost sup-ported the “rule of 80%”.There was an obvious distribution of traits at every sub level.For example,there were 23 different diseases in level III,of which the most common was lymphoma.UPCMC made up 12.3% of all metastatic carcinomas.Multiple NTMN were composed of lymphoma,metastatic car-cinoma and tubercular lymphadenitis,etc.For tubercular lymphadenitis pa-tients,the patients without tubercular toxic symptoms comprised 77.1% of all tubercular lymphadenitis patients.CONCLUSION NTMN are complex and various,with a definite distribu-tion in each neck level.Data relating the sex ratio,UPCMC,multiple nodular NTMN and tubercular lymphadenitis to the clinical traits of NTMN will provide support for clinical applications. 相似文献
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W.Schroeder 《中德临床肿瘤学杂志》2004,3(4):236-239
The standard reconstruction after esophagectomy is the formation of a gastric tube with cervical or intrathoracic esophagogastrostomy. This type of reconstruction is associated with a considerable morbidity and mortality due to anastomotic leakage of the esophagogastrostomy,. Although several etiological factors have been discussed to contribute to this clinically relevant complication ischemia is considered to be the most important one. It is evident that the formation of a gastric tube with mobilization of the stomach, ligation of the left gastric artery and short gastric arteries, 相似文献
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Care professionals (physicians and nurses), administrative staff and hospitalised patients were interviewed to find out the necessary qualities for social workers in oncology, as well as the roles and tasks that they must fulfil. On the one hand, the results of this study show that the needs of the interested parties are indeed met by social service from an empirical perspective of psychosocial support and expert advice. On the other hand, they bring to light the fact that the current status of the social worker is hardly recognized. Confronted with new occupational challenges, the social worker should rethink his/her profession and reevaluate his/her practice. Furthermore, he/she should develop professional links intra- and extramural and participate in social research programs whose aim is to improve the rehabilitation of patients and their families. 相似文献
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ChuanmiaoXie BilingLiang HaogaoUn PeihongWu 《中国肿瘤临床(英文版)》2004,1(5):348-353
OBJECTIVE To investigate the influence of utilizing MRI on the T, N staging system (the 5th edition, UICC) and on the 1992 China staging systems (Fuzhou-Guangzhou,China) by comparing the results of CT and MRI examinations of nasopharyngeal carcinoma (NPC).METHODS All 56 NPC patients, which were confirmed by histology,accepted both CT and MRI examinations. CT system scans were obtained by using an Elscient CT Twin Flash with the conventional axial scan. Three cases were examined by an additional coronary scan and 16 patients received an enhanced CT. The MR imaging was performed with a 0.5T MR system (Philips T5- II Ultra-Magnetic). The conventional axial, sagittal and coronary sections with SE sequences were obtained. The scan field was from the supra sellar cistern to the inferior border of C2. Most patients (50/56) accepted contrast enhanced MRI.RESULTS The pharyngobasilar fascia can clearly be seen on MRI but not on CT, so MRI can accurately determine the lesion in the nasopharyngeal cavity. MRI is more sensitive for evaluation of tumor involvement of soft tissue such as the Iongus colli muscle (14 cases by CT and 26 by MRI), tensor veli patalini muscle and levator veli palatini muscle (17 cases by CT and 23 by MRI), and skull-base bone marrow invasion (15 cases by CT and 42 by MRI). MRI can also demonstrate the invasion of the carotid sheath area and the enlargement of retropharyngeal lymph nodes more definitely than CT.The involvement of the trigeminal nerve can be detected on MRI, which may influence the clinical staging directly.CONCLUSION Of the 56 cases examined, 16 (28.6%) changed the staging based on UICC staging; while 33.9% (19/56) cases changed based on the 1992 China-stagin9 system. The major influence of MRI examinations on the 1992 staging was to differentiate the involvement of the carotid sheath area from metastasis of the retropharyngeal lymph nodes. There also was a significant difference in finding early invasion of the skull base. 相似文献
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From 1970 to 1993, a total of 93 endomf1p4es confirmed by post-mortem examination was diagnosed in the autopsy material of the Berlin Charité, a large hospital with an average of 1,500 hospital beds and maximum medical care. These comprised 51 candidoses (54.8%), 24 aspergilloses (36.6%), five cryptococcoses (5.4%), one zygomycosis, 1 trichosporosis and one coccidioidomycoses. This corresponded to 0.7% of the 13,375 decreased persons autopsied during this period. The frequency of autopsy was 85.3%. In 3,770 cases (2,418 adults and 1,352 children), brain dissection was performed. An adequate clinical putative diagnosis was made in only six out of 28 patients (18 adults, 10 children) with histologically confirmed cerebral mycosis [11 candidoses (39.3%), 10 aspergilloses (35.7%), five cryptococcoses (17.9%), one trichosporosis and one coccidioidomycosis]. About 80% of the mycoses of the CNS thus remained undetected while the patients were alive. Against the background of the continuing reduction in the frequency of autopsy in the Federal Republic of Germany, the observations made in the present paper underscore the demand for improved efficiency of mycological in-vivo diagnoses in the hospital and laboratory. 相似文献