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61.
Suita S Tajiri T Takamatsu H Mizote H Nagasaki A Inomata Y Hara T Okamura J Miyazaki S Kawakami K Eguchi H Tsuneyoshi M;Committee for Pediatric Solid Malignant Tumors in the Kyushu Area Japan 《Journal of pediatric surgery》2004,39(2):195-198
Background/purpose
The survival outcome for patients with hepatoblastoma normally depends on the resectability of the tumor. In Japan, the pre and/or postoperative chemotherapy protocol using a combination of cisplatin (CDDP) and tetrahydropyranyl-Adriamycin (THP-ADR) has been the standard treatment since 1991. This study aims to assess exactly what influence the establishment of this chemotherapy protocol has had on both the tumor resectability and the outcome of patients with hepatoblastoma.Methods
From 1982 to 1997, 60 patients with hepatoblatoma were treated in the Kyushu area, Japan. Based on the pretreatment extent of disease (PRETEXT), the outcome and tumor resectability were compared between group A (1982 to 1990, n = 27, PRETEXT I:5, II:8, III:6, IV:8) and group B (1991 to 1997, n = 33, PRETEXT I:9, II:9, III:5, IV:10).Results
The 5-year survival rates (group A and group B) were 33% and 73% for all cases (P < .01), 100% and 89% for PRETEXT I, 38% and 89% for II (P < .05), 17% and 80% for III (P < .01), and 0% and 40% for IV (P < .01), respectively. The 5-year survival rates for patients with metastases were 0% for group A (n = 5) and 57% for group B (n = 7; P < .01). The rates of a complete resection of primary tumor were 48% for group A and 67% for group B. In particular, a significant difference was found regarding the complete resection rate between groups A and B in the patients with PRETEXT III (17% for group A and 80% for group B; P < .01). In the patients with an incomplete tumor resection (14 for group A, 11 for group B), the 5-year survival rates were 0% for group A and 45% for group B (P < .01).Conclusions
The optimal chemotherapeutic regimen of CDDP and THP-ADR was thus found to greatly contribute to the improved survival rate of hepatoblastoma patients. Preoperative chemotherapy resulted in an increased resectability of the tumor, whereas postoperative chemotherapy played an important role in the increased cure rate of cases with either an incomplete tumor resection or metastasis. However, refractory cases with PRETEXT IV or metastasis may still require the development of an even more effective treatment modality, including the use of blood stem cell transplantation. 相似文献62.
Recent advances in molecular medicine have shown that soluble MHC-multimers can be valuable tools for both the stimulation of as well as the analysis of antigen-specific T cells in vitro. In this review, we describe the use of dimeric major histocompatibility complexes, HLA-Ig, to visualize antigen-specific T cells as well as their potential to stimulate immune responses as part of an artificial antigen-presenting cell (aAPC). The use of HLA-Ig-based aAPC represents an exciting new approach to generate antigen-specific CTL for adoptive immunotherapy that helps to overcome many of the obstacles associated with limitations in current approaches to adoptive immunotherapy. 相似文献
63.
Two cases of an oncocytic adrenal cortical tumor that contained peculiar cytoplasmic crystalline inclusions in the tumor cells are presented. The patients were 49- and 72-year-old females without clinical and biochemical evidence of adrenal cortical or medullary dysfunction. The adrenal tumors weighed 80 and 200 g each. These crystalline inclusions were present in groups of longitudinal profiles or clusters of crossly cut aggregates. They appeared in clusters of membrane-bound columns. On longitudinal sections, they appeared as rigid rods of homogenous density measuring 36 nm in width, but when they were cut transversely their paracrystalline nature became apparent. They were composed of closely packed microtubules in rectangular blocks. The microtubules measured 12.5 nm with a hollow center measuring 4.2 nm. The inclusions were within the membrane-bound cisterna of rough-surfaced endoplasmic reticulum. The significance of these inclusions is not clearly understood; however, they have been seen only in adrenal cortical tumors and their presence may be helpful in the differential diagnosis of adrenal oncocytic tumors. One patient presented with a tumor in which gross and microscopic appearance was compatible with a pheochromocytoma. This case exhibited an oncocytic appearance and pronounced cellular pleomorphism. Ultrastructural studies were necessary to recognize the tumor cells as cortical cells. The tumor cells contained abundant mitochondria with tubular cristae, paranuclear parallel stacks of granular endoplasmic reticulum, and relatively prominent smooth endoplasmic reticulum. These features are typical of adrenocortical cells. In addition, frequent tumor cells contained the peculiar cytoplasmic inclusions herein described. 相似文献
64.
Surgical outcome in 85 patients with primary cardiac tumors 总被引:7,自引:0,他引:7
Bakaeen FG Reardon MJ Coselli JS Miller CC Howell JF Lawrie GM Espada R Ramchandani MK Noon GP Weilbaecher DG DeBakey ME 《American journal of surgery》2003,186(6):641-7; discussion 647
BACKGROUND: We present a large, single institution experience with adult cardiac tumors and address factors affecting outcome. METHODS: A retrospective review was made of all patients who underwent surgery for primary cardiac tumors from April 1975 through August 2002. RESULTS: Eighty-five patients (33 male and 52 female) with a mean age of 54 years were identified with follow-up available for 80 (94%) patients. There were 68 (80%) benign tumors and 17 (20%) malignant tumors. Three tumors recurred and were resected giving a total of 88 surgeries. All benign tumors were grossly resected and the extent of resection for malignant disease ranged from 14 (78%) gross resections and 3 (17%) debulkings to 1 (5%) biopsy. There were 4 (5%) early hospital deaths. Median survival was 9.6 months and 322 months for patients with malignant and benign diseases, respectively. Significant predictors of long-term mortality were malignant disease (P <0.0001) and New York Heart Association class (P <0.03). CONCLUSIONS: Surgical resection provides excellent outcome in patients with benign cardiac tumors. Malignant tumors continue to pose a challenge with good local tumor control but limited survival owing to metastatic disease. 相似文献
65.
Benesch M Lackner H Schagerl S Gallistl S Frey EM Urban C 《Acta paediatrica (Oslo, Norway : 1992)》2001,90(3):264-270
Multimodality treatment approaches have dramatically improved the outcome of patients with intracranial germ cell tumors and are resulting in an increasing number of long-term survivors. The aim of the present study was to evaluate prospectively the development of side effects in children, adolescents and young adults after treatment for intracranial germ cell tumors. Nine patients with a median age of 14 y at diagnosis and a median follow-up of 7.25 y underwent a detailed long-term evaluation including physical and neuro-ophthalmologic examinations, routine laboratory and endocrine stimulation tests, neuropsychometric testing, audiometry and spirometry at repeated intervals. Endocrine deficiencies requiring hormone replacement therapy occurred in all patients. Neuro-ophthalmologic side effects were observed in 8 of the 9 patients, urinary electrolyte wasting in 4 of the 9, alopecia in 3 of the 9 and high-frequency hearing loss in 2 of the 9. Neuropsychologic examinations revealed pathologic results in all five tested patients. Conclusion: The present study indicates that former intracranial germ cell tumor patients suffer from remarkable long-term side effects, and that some of these late effects can develop or worsen months or years after cessation of oncologic therapy. Since life quality is an important parameter of cancer survival, careful follow-up of long-term survivors is mandatory, aimed at counteracting side effects as early as possible and therefore at minimizing long-term morbidity, which may considerably compromise quality of life. 相似文献
66.
Uysal KM Koyuncuoğlu M Akman F Güneri A Sarialioğlu F Kargi A Olgun N Manisali M 《Pediatric hematology and oncology》2001,18(2):147-152
Osteosarcoma of the cranial facial region is uncommon and only rarely involves the ethmoid or sphenoid bones. The authors report on an unusual case of a 17-year-old male presenting with chondroblastic osteosarcoma of the maxillary, ethmoid, and sphenoid sinuses who remains well and disease-free at 46 months. He was treated with anterior craniofacial resection followed by postoperative radiotherapy to the sight of the primary tumor. He did not receive chemotherapy because of emerging hepatitis-B infection and vasculitis. The literature on extragnathic craniofacial osteosarcomas is reviewed with particular emphasis on treatment options of this rare tumor. 相似文献
67.
E. Seretis A. Gavrill N. Agnantis V. Golematis I.E. Voloudakis-Baltatzis 《Ultrastructural pathology》2013,37(6):445-454
The aim of this study was to investigate serotonin and bombesin expression in colorectal adenocarcinomas and neuroendocrine colorectal tumors to clarify their role in the progression of colon cancer. The investigation was carried out by electron microscope immunocytochemistry. The ultrastructural study revealed that some cases of colorectal adenocarcinomas were characterized by the presence of amphicrine cells containing endocrine granules and mucus granules. Poorly differentiated adenocarcinomas and liver metastases were poorly granulated compared with highly differentiated tumors. Neuroendocrine tumors nevertheless were characterized by the presence of numerous malignant neuroendocrine cells filled with secretory granules and mucus granules. Bombesin appeared to be located in enterochromaffin-like endocrine cells, which are primarily responsible for the production of serotonin. In colorectal adenocarcinomas there was an inverse correlation between serotonin levels and the degree of differentiation. High serotonin levels characterized colorectal adenocarcinomas with composite phenotype and colorectal neuroendocrine tumors. Increased bombesin expression was correlated with colorectal adenocarcinomas exhibiting poor histological grade and their liver metastases. In conclusion, the findings suggest that high serotonin levels may be an indicator of neuroendocrine differentiation, and bombesin may be a useful marker for colorectal adenocarcinomas with aggressive behavior. 相似文献
68.
Pheochromocytoma of urinary bladder is rare disease causing a hypertension, palpitation, throbbing headache & hemorrhage induced
by voiding. This case is reported because of rarity of this disease in urinary bladder. 相似文献
69.
本文报告76例第三脑室附近肿瘤。讨论了几种少见的x线征象、颅咽管瘤钙化的阳性率、第三脑室附近肿瘤时蝶鞍的改变等。 相似文献
70.