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81.
Surgical Debulking and Intraperitoneal Chemotherapy for Established Peritoneal Metastases From Colon and Appendix Cancer 总被引:1,自引:1,他引:1
Alfred T Culliford IV MD Ari D. Brooks MD Sunil Sharma MD Leonard B. Saltz MD Gary K. Schwartz MD Eileen M. O’Reilly MD David H. Ilson MD Nancy E. Kemeny MD David P. Kelsen MD Jose G. Guillem MD W Douglas Wong MD Alfred M. Cohen MD Philip B. Paty MD 《Annals of surgical oncology》2001,8(10):787-795
Background: Aggressive treatment of peritoneal metastases from colon cancer by surgical cytoreduction and infusional intraperitoneal (IP) chemotherapy may benefit selected patients. We reviewed our institutional experience to assess patient selection, complications, and outcome.Methods: Patients having surgical debulking and IP 5-fluoro-2-deoxyuridine (FUDR) plus leucovorin (LV) for peritoneal metastases from 1987 to 1999 were evaluated retrospectively.Results: There were 64 patients with a mean age of 50 years. Primary tumor sites were 47 in the colon and 17 in the appendix. Peritoneal metastases were synchronous in 48 patients and metachronous in 16 patients. Patients received IP FUDR (1000 mg/m2 daily for 3 days) and IP leucovorin (240 mg/m2) with a median cycle number of 4 (range, 1–28). The median number of complications was 1 (range, 0–5), with no treatment related mortality. Only six patients (9%) required termination of IP chemotherapy because of complications. The median follow-up was 17 months (range, 0–132 months). The median survival was 34 months (range, 2–132); 5-year survival was 28%. Lymph node status, tumor grade, and interval to peritoneal metastasis were not statistically significant prognostic factors for survival. Complete tumor resection was significant on multivariate analysis (P = .04), with a 5-year survival of 54% for complete (n = 19) and 16% for incomplete (n = 45) resection.Conclusions: Surgical debulking and IP FUDR for peritoneal metastases from colon cancer can be accomplished safely and has yielded an overall 5-year survival of 28%. Complete resection is associated with improved survival (54% at 5 years) and is the most important prognostic indicator.Presented in part at the 54th Annual Cancer Symposium of the Society of Surgical Oncology, Washington, DC, March 15–18, 2001. 相似文献
82.
Little DM; Farrell JG; Cunningham PM; Hickey DP 《QJM : monthly journal of the Association of Physicians》1997,90(10):641-642
Systemic donor infection is regarded as being an absolute contraindication
to cadaveric organ donation for transplantation. This is largely due to
fear of transmitting pathogenic organisms to the immunosuppressed
recipient. However, due to the current shortage of organs available for
transplantation, clinicians are faced with the option of using organs from
'non-ideal' donors, such as those patients with documented evidence of
infection. We report the successful outcome of six orthotopic liver
transplants, 11 renal transplants, one combined heart lung transplant and
one simultaneous kidney and pancreas transplant with organs from eight
donors in whom bacterial meningitis (n = 7) and acute bacterial
epiglottitis (n = 1) were the antecedent causes of death.
相似文献
83.
<Emphasis Type="Italic">BRCA1</Emphasis> and <Emphasis Type="Italic">BRCA2</Emphasis> mutations in a population-based study of male breast cancer 下载免费PDF全文
Victoria?M?Basham Julian?M?Lipscombe Joanna?M?Ward Simon?A?Gayther Bruce?AJ?Ponder Douglas?F?Easton Paul?DP?PharoahEmail author 《Breast cancer research : BCR》2001,4(1):R2
Background
The contribution of BRCA1 and BRCA2 to the incidence of male breast cancer (MBC) in the United Kingdom is not known, and the importance of these genes in the increased risk of female breast cancer associated with a family history of breast cancer in a male first-degree relative is unclear.Methods
We have carried out a population-based study of 94 MBC cases collected in the UK. We screened genomic DNA for mutations in BRCA1 and BRCA2 and used family history data from these cases to calculate the risk of breast cancer to female relatives of MBC cases. We also estimated the contribution of BRCA1 and BRCA2 to this risk.Results
Nineteen cases (20%) reported a first-degree relative with breast cancer, of whom seven also had an affected second-degree relative. The breast cancer risk in female first-degree relatives was 2.4 times (95% confidence interval [CI] = 1.4–4.0) the risk in the general population. No BRCA1 mutation carriers were identified and five cases were found to carry a mutation in BRCA2. Allowing for a mutation detection sensitivity frequency of 70%, the carrier frequency for BRCA2 mutations was 8% (95% CI = 3–19). All the mutation carriers had a family history of breast, ovarian, prostate or pancreatic cancer. However, BRCA2 accounted for only 15% of the excess familial risk of breast cancer in female first-degree relatives.Conclusion
These data suggest that other genes that confer an increased risk for both female and male breast cancer have yet to be found.84.
CH Reynolds BBSc DP Crewther PhD SG Crewther PhD SJ West BSc 《Clinical & experimental ophthalmology》1998,26(S1):S117-S119
85.
86.
A PIL for every ill? Patient information leaflets (PILs): a review of past, present and future use 总被引:9,自引:0,他引:9
Kenny T; Wilson RG; Purves IN; Clark J Sr; Newton LD; Newton DP; Moseley DV 《Family practice》1998,15(5):471-479
This article reviews the usefulness and importance of written information,
specifically leaflets, being given to patients. Evidence suggesting how
both patient and doctor may benefit from the giving of written information
is reviewed. Identification of good practice relating to the content and
readability of leaflets is discussed. An argument is put forward that the
giving of written information is an under-utilized resource in contributing
to improving patient outcomes but that this may be changing with the
increasing use of patient leaflet databases. The advantages and
disadvantages of computer- generated patient leaflets are discussed and
desirable further areas of research on computer-generated leaflets are
proposed.
相似文献
87.
88.
Clinical experience with an endobronchial implant 总被引:1,自引:0,他引:1
89.
90.