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  • 1
    Electronic Resource
    Electronic Resource
    s.l. : American Chemical Society
    Analytical chemistry 61 (1989), S. 1103-1108 
    ISSN: 1520-6882
    Source: ACS Legacy Archives
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Annals of surgical oncology 1 (1994), S. 73-78 
    ISSN: 1534-4681
    Keywords: Adenocarcinoma ; Wide local excision ; Adjuvant therapy ; Duodenum ; Survival
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Because of the rarity of primary adenocarcinoma of the duodenum, accumulation of natural history data has been difficult. As a result, debate continues over important treatment issues. Methods: We did a retrospective review of 67 patients with nonampullary adenocarcinoma of the duodenum treated at the University of Texas M. D. Anderson Cancer Center between 1967 and 1991. Presenting symptoms and signs, diagnostic studies, operation performed, surgical pathology, and survival were analyzed. Results: A primary duodenal tumor was demonstrated by upper gastrointestinal radiographs (UGI) in 37 of 42 patients (88%), esophagogastroduodenoscopy (EGD) in 49 of 55 (89%), and computerized tomograms (CT) in 21 of 42 (50%). A curative resection was performed in 36 of the 59 patients who underwent operation (61%); 27 had pancreaticoduodenectomies and nine had wide local excisions. Overall 5-year survival was 29%. The 5-year survival difference between resected and unresected patients was 54% versus 0%, respectively (p〈0.0001). No survival difference was noted between patients who underwent pancreaticoduodenectomy rather than wide local excision. Lymph node metastases were significantly related to the occurrence of distant metastases (p=0.0034). The 5-year survival for patients with stage I or II tumors was 100% and 52%, respectively, compared to 45% and 0% for stage III and IV (p〈0.0001). Conclusions: Our data suggest that UGI and EGD are effective for diagnosing duodenal carcinoma. Survival is improved by curative resection and is not compromised by a wide local excision instead of a pancreaticoduodenectomy for lesions of the third and fourth portion. We recommend that adjuvant chemotherapy be considered for stage III disease, because distant failure is the predominant pattern of failure in this group.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Annals of surgical oncology 4 (1997), S. 481-490 
    ISSN: 1534-4681
    Keywords: Brain metastases ; Breast cancer ; Chemotherapy ; Radiotherapy ; Surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Patients whose brain metastases from breast cancer are treated nonsurgically have a median length of survival ranging from 2.5 to 7.5 months, and a median time to recurrence ranging from 2 to 5 months. Patients treated with radiotherapy have a median length of survival ranging from 3 to 4 months. Those treated with chemotherapy have a median length of survival ranging from 5.5 to 7.5 months. Methods: We conducted a retrospective analysis on 63 patients treated over a 10-year period. Only patients who underwent surgery for nonrecurrent brain metastases were studied. Sixty-one patients (97%) underwent surgery within 2 weeks of diagnosis of the brain metastases. Results: The median length of survival was 16 months (95% confidence interval [CI] 11 to 22 months), and the 5-year survival rate was 17% (CI 9% to 29%). Brain metastases recurred in 27 patients at a median interval of 15 months (CI 12 to 24 months). Eleven patients had local recurrence, 10 had distal recurrence, and seven developed leptomeningeal disease. Significant prognosticators of length of survival were age (p=0.011), menopause status (p=0.10), postoperative radiotherapy (p=0.054), preoperative neurologic status (p=0.011), and preoperative systemic disease status (p=0.0003). Systemic disease status had a significant effect on the length of survival but not on the time to recurrence.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neuro-oncology 27 (1996), S. 269-277 
    ISSN: 1573-7373
    Keywords: surgery ; brain metastasis ; intraoperative ultrasound ; cortical mapping ; radiosurgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The most common structural neurologic complication of systemic cancer is brain metastasis. For the most part, treatment is palliative because the majority of patients (≥ 50%) have uncontrollable systemic cancer. However, for patients in whom the only metastasis is to the brain, death is more likely to result from the metastasis than from the systemic disease; hence, treatment of the metastasis is vitally important. Although radiotherapy is generally considered the preferred treatment, surgical removal of the mass, whether single or multiple, may be the most effective palliation, especially for tumors from radio-resistant diseases such as melanoma, kidney and colon cancer. We review the information regarding therapeutic decision-making; advances in surgical procedures, namely computer-assisted stereotactic and/or intraoperative ultrasound and mapping techniques; the efficacy of postoperative WBRT; complications and benefits of surgery; our experience with reoperation for recurrent metastatic brain tumors, the results of which indicate that reoperation for recurrent brain metastasis can prolong survival and improve quality of life for most individuals; our results comparing surgery versus radiosurgery, which show that patients who undergo surgical treatment live longer and have better tumor control than those treated with radiosurgery; and the patient's prognosis. The conclusion is that surgery should remain the treatment of choice whenever possible.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neuro-oncology 42 (1999), S. 227-231 
    ISSN: 1573-7373
    Keywords: extent ; resection ; prognostic ; glioma ; survival ; bias
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The published neurosurgical literature remains unclear as to whether the extent of surgical resection statistically correlates with survival. The possible sources of this current state of confusion and lack of concordance between studies are numerous: different distributions of covariates, different classification criteria, differences in patient selection, and various methodological flaws. Almost all of the modern studies are retrospective and thus subject to numerous sources of bias and variation. Additional retrospective studies and poorly designed prospective studies will not clarify the effect of extent of surgery on survival. In the absence of randomized experiments with well-defined protocols for aggressive and conservative surgery, well-planned and carefully executed prospective observational studies are needed. In the meantime, we are left with the conclusion that little scientifically credible evidence is available to support the assertion that aggressive surgical resection prolongs survival.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neuro-oncology 40 (1998), S. 51-57 
    ISSN: 1573-7373
    Keywords: MIB-1 ; ependymoma ; Ki-67 ; proliferation index ; brain tumor ; survival
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The biologic behavior of ependymomas is highly variable, and its correlation with histologic features is at best imprecise. This retrospective study attempted to correlate the malignant histologic characteristics of ependymomas with MIB-1 proliferation index and survival. Biopsy and resection specimens taken from 34 patients who received treatment 1972 to 1996 were histologically examined. The patients' ages range was 1 to 59 years. The histologic specimens were assessed for anaplastic features (necrosis, mitosis, vascular proliferation, cellular pleomorphism, and overlapping of nuclei) and an MIB-1 (Ki-67 antigen) proliferation index was also determined. The overall median MIB-1 proliferation index was 7.8% (range 0.1 – 62.5%). An MIB-1 of 20% was significant for a decrease in survival (RR=5.7) (p=0.0013). The median MIB-1 for patients 〈 20 years old was 20.6% with range (0.1, 43%), while that for patients 〉 20 years was 5.1% (range 0.2, 9.4%) (KW p=0.055). Three of 5 histological features evaluated were significantly associated with outcome: 〉 5 mitotic figures per high-power field, necrosis, and vascular proliferation, but not nuclear overlap or pleomorphism. All pathologic factors except pleomorphism were significantly related to the MIB-1 proliferation index. In brief, our data support the association of poor prognoses in ependymomas with young age, the presence of three to four anaplastic histologic features, and an MIB-1 proliferation index 〉 20%.
    Type of Medium: Electronic Resource
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