Objective： This retrospective study was designed to evaluate ciinico-pathological data including stage, results of treatment, and prognostic factors which affect the overall survival ＆ disease free survival. Methods...Objective： This retrospective study was designed to evaluate ciinico-pathological data including stage, results of treatment, and prognostic factors which affect the overall survival ＆ disease free survival. Methods： This was a retrospective study carried out at the Radiotherapy Department, National Cancer Institute, Cairo University, Egypt on 1009 patients treated for primary breast cancer between 1999-2003. Results： The median follow-up was 68 months. Loco regional relapse occurred in 23 patients （2.3%） and distant relapse occurred in 203 patients （20.1%）. Both Ioco regional and distant relapse were reported in 32 patients （3.2%）. The disease free survival （DFS） at 3 and 5 years were 87% and 78% respectively, while OAS at 3 and 5 years were 96.4% and 91.4% respectively. Multivariate analysis of different prognostic factors showed that the independent bad prognostic factors in the study for disease relapse were positive lymph nodes （LNs, more than 10）, tumor size T3, T4 with significance of 0.0001 for each, and pathologic grade with significance of 0.003. Conclusion： The most important independent bad prognostic factors for relapse are positive LNs more than 10, tumor size T3, T4 and pathologic grade. The timing of radiotherapy affects the disease free survival significantly also it is recommended to analyze the group of patients with LNs negative using well designed randomized trials.展开更多
OBJECTIVE To explore the methods and experience of thesingle-nostril transsphenoidal approach for treating pituitaryadenomas.METHODS We retrospectively analyzed 46 patients whohad pituitary tumors and received surgery...OBJECTIVE To explore the methods and experience of thesingle-nostril transsphenoidal approach for treating pituitaryadenomas.METHODS We retrospectively analyzed 46 patients whohad pituitary tumors and received surgery via the singlenostriltranssphenoidal approach and observed the effects andcomplications of surgery. The specific surgical methods are: a nasalspeculum is inserted slowly through the right nostril towards theanterior wall of the sphenoid sinus. A 1.5 cm incision is made intothe nasal mucosa in the right nasal cavity at the level of the middlenasal turbinate. By fracturing the bony septum, a space is formedbetween the bilateral nasal mucosa and the bony septum of thesphenoid sinus. Then, the inside of the sphenoid sinus is exposed.The remaining part of the bony septum, the anterior sphenoidsinus wall, and the sphenoid mucosa are gradually removed. Theanterior sphenoidotomy is less than 1.5 cm wide. After confirmingthe tumor by dural puncture, a cross incision of the dura is made,and the tumor is slowly removed by curette. The sella is usuallycollapsed and visible after the total tumor removal. When thetumor is resected satisfactorily, gelatin sponges are placed into theoperative cavity to stop bleeding.RESULTS Postoperative MRI scans revealed that among the 46cases, total resection of the tumor was achieved in 34 cases andsubtotal in 12. No deaths or disability occurred, and the hormonelevels of almost all patients improved. Signs of diabetes insipidusoccurred in 17, electrolyte disturbances in 5, and there were noreports of postoperative cerebrospinal fluid rhinorrhea.CONCLUSION The direct single nostril transsphenoidalapproach of continuous improvement has the advantages ofa convenient approach, simplified operation, safety and highefficiency.展开更多
文摘Objective： This retrospective study was designed to evaluate ciinico-pathological data including stage, results of treatment, and prognostic factors which affect the overall survival ＆ disease free survival. Methods： This was a retrospective study carried out at the Radiotherapy Department, National Cancer Institute, Cairo University, Egypt on 1009 patients treated for primary breast cancer between 1999-2003. Results： The median follow-up was 68 months. Loco regional relapse occurred in 23 patients （2.3%） and distant relapse occurred in 203 patients （20.1%）. Both Ioco regional and distant relapse were reported in 32 patients （3.2%）. The disease free survival （DFS） at 3 and 5 years were 87% and 78% respectively, while OAS at 3 and 5 years were 96.4% and 91.4% respectively. Multivariate analysis of different prognostic factors showed that the independent bad prognostic factors in the study for disease relapse were positive lymph nodes （LNs, more than 10）, tumor size T3, T4 with significance of 0.0001 for each, and pathologic grade with significance of 0.003. Conclusion： The most important independent bad prognostic factors for relapse are positive LNs more than 10, tumor size T3, T4 and pathologic grade. The timing of radiotherapy affects the disease free survival significantly also it is recommended to analyze the group of patients with LNs negative using well designed randomized trials.
文摘OBJECTIVE To explore the methods and experience of thesingle-nostril transsphenoidal approach for treating pituitaryadenomas.METHODS We retrospectively analyzed 46 patients whohad pituitary tumors and received surgery via the singlenostriltranssphenoidal approach and observed the effects andcomplications of surgery. The specific surgical methods are: a nasalspeculum is inserted slowly through the right nostril towards theanterior wall of the sphenoid sinus. A 1.5 cm incision is made intothe nasal mucosa in the right nasal cavity at the level of the middlenasal turbinate. By fracturing the bony septum, a space is formedbetween the bilateral nasal mucosa and the bony septum of thesphenoid sinus. Then, the inside of the sphenoid sinus is exposed.The remaining part of the bony septum, the anterior sphenoidsinus wall, and the sphenoid mucosa are gradually removed. Theanterior sphenoidotomy is less than 1.5 cm wide. After confirmingthe tumor by dural puncture, a cross incision of the dura is made,and the tumor is slowly removed by curette. The sella is usuallycollapsed and visible after the total tumor removal. When thetumor is resected satisfactorily, gelatin sponges are placed into theoperative cavity to stop bleeding.RESULTS Postoperative MRI scans revealed that among the 46cases, total resection of the tumor was achieved in 34 cases andsubtotal in 12. No deaths or disability occurred, and the hormonelevels of almost all patients improved. Signs of diabetes insipidusoccurred in 17, electrolyte disturbances in 5, and there were noreports of postoperative cerebrospinal fluid rhinorrhea.CONCLUSION The direct single nostril transsphenoidalapproach of continuous improvement has the advantages ofa convenient approach, simplified operation, safety and highefficiency.
