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The Netherlands journal of surgery最新文献

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Breast-conserving therapy for invasive carcinoma: diagnosis of local recurrence. 浸润性癌保乳治疗:局部复发的诊断。
The Netherlands journal of surgery Pub Date : 1991-08-01
E J Rutgers, A B van Rossum, J L Peterse, P Cohen, J H Borger, H W Kemperman
{"title":"Breast-conserving therapy for invasive carcinoma: diagnosis of local recurrence.","authors":"E J Rutgers,&nbsp;A B van Rossum,&nbsp;J L Peterse,&nbsp;P Cohen,&nbsp;J H Borger,&nbsp;H W Kemperman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The way in which local recurrence after breast conserving treatment for invasive carcinoma became apparent, is reported in 44 patients. All patients were followed by regular physical examination and annual mammography. In 36 patients first suspicion of local recurrence was heralded by clinical signs and symptoms, presented between two scheduled routine visits in 12 patients, and at the time of a routine visit in 14 patients. Routine physical examination by surgeon or radiotherapist revealed local recurrence in 10 patients. Local recurrence was detected only by mammography in eight patients. Mammography confirmed the clinical suspicion in seven patients. The remaining 23 patients with clinical overt recurrence showed no signs of recurrent tumour on the mammographs performed after first clinical suspicion. Fine needle aspiration (FNA) cytology confirmed the clinical suspicion in 35 of the 38 tested patients. In our experience, regular physical examination is the mainstay for the detection of local recurrence after breast conserving therapy. Mammography was of limited value but proved more valuable for the early detection of recurrent tumour outside the primary tumour area. Fine needle aspiration cytology is a helpful tool in confirming the diagnosis of local recurrence.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 4","pages":"110-3"},"PeriodicalIF":0.0,"publicationDate":"1991-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13103026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pulmonary metastasectomy by median sternotomy. 胸骨正中切开肺转移切除术。
The Netherlands journal of surgery Pub Date : 1991-08-01
H J Rutten, A N van Geel, B van Ooijen
{"title":"Pulmonary metastasectomy by median sternotomy.","authors":"H J Rutten,&nbsp;A N van Geel,&nbsp;B van Ooijen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The results of pulmonary metastasectomy by a median sternotomy approach were retrospectively studied in 38 patients. This approach enabled the exploration of both thoracic cavities and, subsequently, the detection of other metastases. Such occult metastases were present in 11 of the 38 patients, four patients had unsuspected metastases at the contralateral side. There was no postoperative mortality, the morbidity associated with the median sternotomy and bilateral exploration was low. Pneumothorax occurred in three patients, pulmonary infection in four patients and a superficial wound infection in one patient. Hospital stay ranged from 4-25 days (mean 10 days). The five-year actuarial survival rate was 15 per cent. Resectability did not correlate significantly with long-term survival, neither did primary histology, disease-free interval or the presence of bilateral disease. The number of metastases was a highly significant predictor of survival (p = 0.0004).</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 4","pages":"126-8"},"PeriodicalIF":0.0,"publicationDate":"1991-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13103028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Haematogenous tumour growth in the inferior vena cava in a patient with a nonseminomatous testicular tumour. 非半胱癌性睾丸肿瘤患者下腔静脉血液肿瘤生长。
The Netherlands journal of surgery Pub Date : 1991-08-01
S J Ham, H Schraffordt Koops, D T Sleijfer, N M Freling, W M Molenaar
{"title":"Haematogenous tumour growth in the inferior vena cava in a patient with a nonseminomatous testicular tumour.","authors":"S J Ham,&nbsp;H Schraffordt Koops,&nbsp;D T Sleijfer,&nbsp;N M Freling,&nbsp;W M Molenaar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The case history is reported of a patient with an invasion of the inferior vena cava by metastases of a non-seminomatous testicular tumour. He was treated with combination chemotherapy, followed by laparotomy and resection of residual tumour tissue. Fourteen months after this operation he is in good health. For every retroperitoneal lymph node dissection it is necessary to be on the look-out for invasion of the vena cava, because of the risk of a sudden pulmonary embolism.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 4","pages":"133-4"},"PeriodicalIF":0.0,"publicationDate":"1991-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13103030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical oncology: a permanent challenge. 外科肿瘤学:一个永久的挑战。
The Netherlands journal of surgery Pub Date : 1991-08-01
{"title":"Surgical oncology: a permanent challenge.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 4","pages":"83-4"},"PeriodicalIF":0.0,"publicationDate":"1991-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13103031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hepatic metastases: comparative study of diagnostic ultrasound, CT, nuclear scintigraphy and laboratory tests. 肝转移:超声、CT、核显像和实验室检查的比较研究。
The Netherlands journal of surgery Pub Date : 1991-08-01
L M de Brauw, C J van de Velde, E K Pauwels, R Bok, J L Bloem, J C Aarts, J Hermans
{"title":"Hepatic metastases: comparative study of diagnostic ultrasound, CT, nuclear scintigraphy and laboratory tests.","authors":"L M de Brauw,&nbsp;C J van de Velde,&nbsp;E K Pauwels,&nbsp;R Bok,&nbsp;J L Bloem,&nbsp;J C Aarts,&nbsp;J Hermans","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Computed tomography, ultrasound, nuclear scintigraphy, and laboratory tests (lactic dehydrogenase, alkaline phosphatase, and 5-nucleotidase) were compared in 135 patients with gastro-intestinal carcinoma to define the most useful test to detect hepatic metastases. Thirty-six patients (26.7 per cent) had hepatic metastases at laparotomy. Sensitivities were low: 46.2 per cent for nuclear scintigraphy, 57.6 per cent for ultrasound, 67.7 per cent for computed tomography and 62.9 per cent for lactic dehydrogenase. Accuracies ranged from 62.9 (lactic dehydrogenase) to 77.6 per cent (nuclear scintigraphy). No significant differences were found. Accurate and efficient detection of hepatic metastases is hampered by relatively low sensitivity, specificity and accuracy of the conventional imaging tests and laboratory tests.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 4","pages":"92-4"},"PeriodicalIF":0.0,"publicationDate":"1991-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13104509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Elective lymph node dissection in melanoma: still a controversial issue. 选择性淋巴结清扫在黑色素瘤:仍然是一个有争议的问题。
The Netherlands journal of surgery Pub Date : 1991-08-01
B B Kroon, A Jonk
{"title":"Elective lymph node dissection in melanoma: still a controversial issue.","authors":"B B Kroon,&nbsp;A Jonk","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Clinically not suspected regional lymph node areas are usually left in situ in patients with a primary melanoma with a Breslow thickness of 1.5 mm or less. In patients with melanomas more than 4 mm thick, elective dissection has also little or no effect on survival, because the frequent haematogenous micrometastases determine the prognosis. There is no agreement on the policy concerning elective lymph node dissection in patients with melanoma thicknesses between 1.5 and 4 mm. Some favour a wait-and-see policy, basing their arguments on the results of a WHO prospective trial. Others recommend elective node dissections in these patients, based on the results from a number of large, well-analysed retrospective studies and because of objections against the WHO trial. More prospective comparative studies and research aiming at direct clinical detection of microscopical (occult) lymph node metastases will have to be carried out before a consensus may be reached on the benefit of intervention in this category of patients.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 4","pages":"129-32"},"PeriodicalIF":0.0,"publicationDate":"1991-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13103029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Breast-conserving treatment of early breast cancer: survival and recurrence in community hospitals in southeastern Netherlands. 早期乳腺癌保乳治疗:荷兰东南部社区医院的生存和复发
The Netherlands journal of surgery Pub Date : 1991-08-01
A C Voogd, J W Coebergh, M A Crommelin, L H van der Heyden, H M Kluck
{"title":"Breast-conserving treatment of early breast cancer: survival and recurrence in community hospitals in southeastern Netherlands.","authors":"A C Voogd,&nbsp;J W Coebergh,&nbsp;M A Crommelin,&nbsp;L H van der Heyden,&nbsp;H M Kluck","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A total of 514 patients with malignant breast tumours (3 cm or less in diameter) and without evidence of distant metastases underwent tumour excision, axillary dissection and radiotherapy in nine community hospitals in southeastern Netherlands and a regional institute for radiotherapy (1981-1987). Follow-up ranged from 16 to 109 months, mean 50 months. The five-year overall survival was 87 per cent and the breast cancer specific survival 90 per cent. The five-year disease-free survival was 78 per cent. The local recurrence rate was 4.4 per cent at five years and the regional recurrence rate 4.5 per cent. Survival and local recurrence rate were in accordance with the early results reported by leading centres. The regional recurrence rate seemed to be somewhat higher. This study indicates that patients with early breast cancer can be treated effectively and safely with breast-conserving therapy in community hospitals.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 4","pages":"105-9"},"PeriodicalIF":0.0,"publicationDate":"1991-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13103025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Local treatment of liver metastases with recombinant tumour necrosis factor (rTNF): a phase one study. 重组肿瘤坏死因子(rTNF)局部治疗肝转移:一项一期研究
The Netherlands journal of surgery Pub Date : 1991-08-01
J N IJzermans, G P van der Schelling, M Scheringa, T A Splinter, R L Marquet, J Jeekel
{"title":"Local treatment of liver metastases with recombinant tumour necrosis factor (rTNF): a phase one study.","authors":"J N IJzermans,&nbsp;G P van der Schelling,&nbsp;M Scheringa,&nbsp;T A Splinter,&nbsp;R L Marquet,&nbsp;J Jeekel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fifteen patients with therapy-resistant liver metastases were treated in a phase-I study with recombinant human TNF (rTNF). The rTNF was injected into one liver metastasis by ultrasound guidance, using a 50 microgram escalating dose schedule (3 patients/dosage) ranging from 100-350 micrograms/injection. Influenza-like symptoms like fever, chills, nausea and vomiting were the main clinical side effects. Two patients, treated concomitantly with rTNF and morphine, showed mild hypotension. Other toxicities, as reported after systemic use of rTNF, such as decrease in leukocyte and platelet counts, renal or liver toxicity were not observed. In eight patients growth arrest was observed in rTNF-treated metastases, whereas non-injected lesions showed growth progression. The maximum tolerated dose by this route of administration is greater than 350 micrograms/injection. Based on these observations it is concluded that the toxicity of rTNF injected into liver metastases by sonographic control is transient and mild and that intratumoural administration of rTNF might play a role in local tumour control.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 4","pages":"121-5"},"PeriodicalIF":0.0,"publicationDate":"1991-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13103027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The influence of blood loss on tumour growth: effect and mechanism in an experimental model. 失血对肿瘤生长的影响:实验模型的作用和机制。
The Netherlands journal of surgery Pub Date : 1991-08-01
M A Hoynck van Papendrecht, O R Busch, J Jeekel, R L Marquet
{"title":"The influence of blood loss on tumour growth: effect and mechanism in an experimental model.","authors":"M A Hoynck van Papendrecht,&nbsp;O R Busch,&nbsp;J Jeekel,&nbsp;R L Marquet","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Retrospective studies have provided indirect evidence that allogeneic blood transfusion may adversely influence the prognosis of cancer patients. This effect may be prevented by using autologous blood transfusions. However, this involves preoperative donation of blood, the consequences of which are still unknown. The aim of the present study was to investigate the possible effects of blood loss on tumour growth and on NK-cell activity. An artificial lung metastasis model was used in the BN rat from which 20 per cent of the blood volume was taken at different time intervals. The results showed that blood loss, one day prior to tumour challenge, had a profound stimulating effect on tumour growth. After blood loss, the number of lung metastases was doubled as compared to controls. This tumour-promoting effect could be prevented by an immediate plasma transfusion, but not by evoking a normal haemoglobin level after blood loss by pretreatment with recombinant erythropoietin (rEpo). The NK-cell activity of spleen cells was significantly depressed, 24 hours after blood loss. At a 50:1-lymphocyte-to-target cell ratio, the NK-cell activity dropped from 25.3 per cent in controls to 9.3 per cent in experimental animals. Since NK-cells are assumed to play a role in the clearance of tumour cells from the circulation, the enhanced tumour growth observed after blood loss might be caused by this depression.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 4","pages":"85-8"},"PeriodicalIF":0.0,"publicationDate":"1991-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13103032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Changing indications for breast conserving therapy: proportion of patients with operable breast cancer suitable for breast conservation. 保乳治疗适应症的改变:可手术乳腺癌患者适合保乳的比例。
The Netherlands journal of surgery Pub Date : 1991-08-01
M J Hooning, J A van Dongen, G Went
{"title":"Changing indications for breast conserving therapy: proportion of patients with operable breast cancer suitable for breast conservation.","authors":"M J Hooning,&nbsp;J A van Dongen,&nbsp;G Went","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The changes in indication for breast conserving therapy and the proportion of operable stage-I and stage-II breast cancers suitable for breast conserving therapy were studied in three time periods. The percentage of patients treated with breast conserving therapy gradually increased through the years: 77/199 (39%) in 1980-1981, 122/245 (50%) in 1985-1987, and 168/305 (55%) in 1987-1989. Using the actual selection criteria more patients might have been candidates for breast conserving therapy: 69, 64 and 59 per cent respectively. In the period 1987-1989 almost all patients who were considered good candidates for breast conserving therapy had a breast sparing procedure. Indications widened in relation to age limit (less than or equal to 70 years) and, over the years, more factors became relative contra-indications: very young age, presence of extensive intra-ductal component, data from mammography (multicentricity, size and aspect of the lesion). About 40 per cent of the patients were no appropriate candidates for breast conserving therapy. This percentage would be higher when operable stage-III patients would have been included.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 4","pages":"102-4"},"PeriodicalIF":0.0,"publicationDate":"1991-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13103024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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