Background:The possibility of treating skin carcinomas of the pinna with radiotherapy is somewhat under discussion and scarcely known.Therefore the aim of the study was to evaluate the effectiveness and safety of derm...Background:The possibility of treating skin carcinomas of the pinna with radiotherapy is somewhat under discussion and scarcely known.Therefore the aim of the study was to evaluate the effectiveness and safety of dermatologic radiotherapy in a series of patients affected by basal or squamous cell carcinoma of the pinna. Methods:A retrospective study was performed on 108 patients affected by 115 carcinomas of the pinna (99 basal cell carcinomas, 16 squamous cell carcinomas) without involvement of the external auditory canal. Radiotherapy was performed with kilovoltage techniques (55-120 kV) and the total doses administered ranged from 45 to 70 Gy (105 Gy in one case only), with different fractionations. Results:The mean follow-up was 28.80 months. Complete remission was obtained in 111 lesions (96.52%) and partial remission in one (0.87%), as evaluated 1 month after the end of radiotherapy. No response was observed in two lesions (1.74%). The response was not evaluable in one lesion (0.87%). During follow up a relapse was observed in 12 lesions (all basal cell carcinomas):nine central and three marginal to the irradiation field. The 5-year cure-rate from the end of radiotherapy was 78%. The cosmeticresultswereevaluatedasgoodoracceptablein88.28%of lesions. No complications nor sequelae to the treatment were observed. Conclusions:The results obtained confirm the possibility of treating epithelial skin neoplasms of the pinna with dermatologic radiotherapy, which can afford high-remission percentages without damaging cartilaginous tissue.展开更多
Objective: In this study, we measured both thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD) levels, and then determined the TP/DPD ratios, in a number of invasive cervical cancers. Our aim was to...Objective: In this study, we measured both thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD) levels, and then determined the TP/DPD ratios, in a number of invasive cervical cancers. Our aim was to investigate the association between these values and the clinicopathological features of invasive cervical cancer, including patient prognosis. Study design: Using enzyme-linked immunosorbent assays, the TP and DPD activities were quantitatively measured in 51 patients with cervical cancer who had also undergone a radical hysterectomy. Results: The TP, DPD and TP/DPD values in squamous cell carcinoma (SCC) were found to be significantly higher than the levels in non-SCC. Furthermore, in a SCC subgroup, the TP/DPD levels were significantly higher in cases where parametrial invasion was evident, and in a non-SCC subgroup, these levels were also significantly higher in cases with deep stromal invasion, lymph-vascular space invasion, large tumor size and parametrial invasion. The disease-free survival rate is shown to be significantly higher in patients with low TP/DPD levels indicating that this ratio may be associated with both the progression and recurrence of invasive cervical cancer. Conclusion: TP/DPD ratios may be associated with both the progression and recurrence of invasive cervical cancer.展开更多
Goals and Background: There are great differences between treatment methods for early-stage esophageal cancer in institutions. Radiation therapy has been considered to be an effective modality as organ-preserving trea...Goals and Background: There are great differences between treatment methods for early-stage esophageal cancer in institutions. Radiation therapy has been considered to be an effective modality as organ-preserving treatment of the disease. The aim of this study is to assess the effect and limitation of radiation therapy on patients with early esophageal cancer. Study: The subjects were 38 patientswith stage I (T1N0M0) squamous cell carcinoma of the esophagus who had received definitive radiation therapy alone. Eleven tumors were assessed within the mucosal layer, whereas 27 tumors showed submucosal invasion by examination using endoscopic ultrasound. All patients were treated with more than 60 Gy using a conventional daily fractionation dose at 2 Gy. An additional boost with brachytherapy was performed for 20 patients, and the prescribed doses were 10 Gy (5 Gy ×2 times) with low dose rate (8 patients) and 9 Gy (3 Gy ×3 times) with high dose rate (12 patients). Outcomes and prognostic factors, including the efficacy of intraluminal brachytherapy, were investigated. Results: The cause-specific survival rate and the local control rate at 5 yearswere 82.6%and 86.3%, respectively. Recurrences were noted in 8 patients with submucosal cancer, but no recurrence was observed in patients with mucosal cancer. In the present study, tumor length was a statistically significant prognostic factor for cause-specific survival (P = 0.018) and tumor depth tended toward statistical significance (P = 0.073). In 27 patientswith submucosal cancer, the tumor length was also statistically significant for the survival (P = 0.032). The 5-year cause-specific survival rates for the short tumor group and the long tumor groupwere 85.7%and 55.6%, respectively. On the other hand, the use of intraluminal brachytherapy had no significant effect on patient survival. Conclusion: Radiation therapy is very effective for early esophageal squamous cell carcinoma with tumor length less than 5 cm, but other treatment modalities, including chemoradiotherapy especially for inoperable patients, should be considered for submucosal cancer with a tumor length of 5 cm or more.展开更多
Introduction. Squamous cell carcinoma is a malignant epithelial tumor of the skin, rarely observed in "black"skin. It often complicates an acquired or congenital pre-neoplastic dermatosis. We report on 80 ca...Introduction. Squamous cell carcinoma is a malignant epithelial tumor of the skin, rarely observed in "black"skin. It often complicates an acquired or congenital pre-neoplastic dermatosis. We report on 80 cases of squamous cell carcinoma having occurred in black African patients from Senegal. Patients and methods. We retrospectively analyzed all the medical files of patients followed-up in the department for histologically confirmed squamous cell carcinoma from 1980 to 1999. Results. Eighty cases of carcinoma were collected. The mean age of the patients was of 47 years (range: 1 to 85) and the sex ratio was of 1.35 (46 men and 34 women). A pre-neoplastic dermatosis was identified in 65%of the patients. Acquired pre-neoplastic dermatosis was: heat burn scars (15 cases), chronic discoid lupus erythematosus (6 cases) and chronic phagedenic ulcer (4 cases). Pre-neoplastic genodermatoses were: albinism (6 cases), xeroderma pigmentosum (5 cases) and epidermodysplasia verruciformis (1 case). Lesions were multiple and cephalic in patients with genodermatosis. Death due to carcinoma occurred in 8 patients. Comments. This large series of squamous cell carcinoma emphasizes: the rarity of squamous cell carcinomas in black patients and the frequency of its occurrence on acquired pre-existing dermatosis. For many years phagedenic ulcers predominated. Our results show the regression of the latter and its increase on post-burn scars and chronic lupus erythematosus. Pre-neoplastic genodermatoses thatdeterminemultiplecancers,usuallylocatedonsun-exposed areas and occurring in young patients, are particularly severe.展开更多
Based on the reduced morbidity seen in our retrospective study, we undertook a prospective, randomized trial to determine whether transposition of the sartorius muscle improves postoperative morbidity in women with sq...Based on the reduced morbidity seen in our retrospective study, we undertook a prospective, randomized trial to determine whether transposition of the sartorius muscle improves postoperative morbidity in women with squamous cell carcinoma of the vulva undergoing inguinal- femoral lymphadenectomy. Patients with squamous carcinoma of the vulva requiring inguinal- femoral lymphadenectomywere randomized to undergo sartorius transposition or not. All patients received perioperative antibiotics, DVT prophylaxis, and closed suction surgical site drainage. Outcomes assessed include wound cellulitis, wound breakdown, lymphocyst formation, lymphedema, and/or rehospitalization. Cohorts were compared using Fisher’ s exact test. Baseline characteristics were compared using Student’ s t test or Fischer’ s exact test as appropriate. Logistic regression was used to assess the impact of sartorius trans position, after adjusting for other factors. From June 1996 to December 2002, 61 patients underwent 99 inguinal- femoral lymphadenectomies, 28 with sartorius transposition, and 33 without. The mean (SD) age for controls and patients undergoing sartorius transpositionwas 63.5 (15.2) and 73.8 (13.7) years, respectively (P < 0.05). There were no statistically significant differences in BSA, tobacco use, co- morbid medical conditions, past surgical history, medication use, size of incision, duration of surgery, number of positive lymph nodes, pathologic stage, pathologic grade, pre- or postoperative hemoglobin, or length of hospitalization. Therewere no statistically significant differences in the incidence of wound cellulitis, wound breakdown, lymphedema, or rehospitalization. The incidence of lymphocyst formation was increased in the sartorius transposition group. After adjusting for age, however, the groups appeared similar. Sartorius transposition after inguinal- femoral lymphadenectomy does not reduce postoperative wound morbidity.展开更多
文摘Background:The possibility of treating skin carcinomas of the pinna with radiotherapy is somewhat under discussion and scarcely known.Therefore the aim of the study was to evaluate the effectiveness and safety of dermatologic radiotherapy in a series of patients affected by basal or squamous cell carcinoma of the pinna. Methods:A retrospective study was performed on 108 patients affected by 115 carcinomas of the pinna (99 basal cell carcinomas, 16 squamous cell carcinomas) without involvement of the external auditory canal. Radiotherapy was performed with kilovoltage techniques (55-120 kV) and the total doses administered ranged from 45 to 70 Gy (105 Gy in one case only), with different fractionations. Results:The mean follow-up was 28.80 months. Complete remission was obtained in 111 lesions (96.52%) and partial remission in one (0.87%), as evaluated 1 month after the end of radiotherapy. No response was observed in two lesions (1.74%). The response was not evaluable in one lesion (0.87%). During follow up a relapse was observed in 12 lesions (all basal cell carcinomas):nine central and three marginal to the irradiation field. The 5-year cure-rate from the end of radiotherapy was 78%. The cosmeticresultswereevaluatedasgoodoracceptablein88.28%of lesions. No complications nor sequelae to the treatment were observed. Conclusions:The results obtained confirm the possibility of treating epithelial skin neoplasms of the pinna with dermatologic radiotherapy, which can afford high-remission percentages without damaging cartilaginous tissue.
文摘Objective: In this study, we measured both thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD) levels, and then determined the TP/DPD ratios, in a number of invasive cervical cancers. Our aim was to investigate the association between these values and the clinicopathological features of invasive cervical cancer, including patient prognosis. Study design: Using enzyme-linked immunosorbent assays, the TP and DPD activities were quantitatively measured in 51 patients with cervical cancer who had also undergone a radical hysterectomy. Results: The TP, DPD and TP/DPD values in squamous cell carcinoma (SCC) were found to be significantly higher than the levels in non-SCC. Furthermore, in a SCC subgroup, the TP/DPD levels were significantly higher in cases where parametrial invasion was evident, and in a non-SCC subgroup, these levels were also significantly higher in cases with deep stromal invasion, lymph-vascular space invasion, large tumor size and parametrial invasion. The disease-free survival rate is shown to be significantly higher in patients with low TP/DPD levels indicating that this ratio may be associated with both the progression and recurrence of invasive cervical cancer. Conclusion: TP/DPD ratios may be associated with both the progression and recurrence of invasive cervical cancer.
文摘Goals and Background: There are great differences between treatment methods for early-stage esophageal cancer in institutions. Radiation therapy has been considered to be an effective modality as organ-preserving treatment of the disease. The aim of this study is to assess the effect and limitation of radiation therapy on patients with early esophageal cancer. Study: The subjects were 38 patientswith stage I (T1N0M0) squamous cell carcinoma of the esophagus who had received definitive radiation therapy alone. Eleven tumors were assessed within the mucosal layer, whereas 27 tumors showed submucosal invasion by examination using endoscopic ultrasound. All patients were treated with more than 60 Gy using a conventional daily fractionation dose at 2 Gy. An additional boost with brachytherapy was performed for 20 patients, and the prescribed doses were 10 Gy (5 Gy ×2 times) with low dose rate (8 patients) and 9 Gy (3 Gy ×3 times) with high dose rate (12 patients). Outcomes and prognostic factors, including the efficacy of intraluminal brachytherapy, were investigated. Results: The cause-specific survival rate and the local control rate at 5 yearswere 82.6%and 86.3%, respectively. Recurrences were noted in 8 patients with submucosal cancer, but no recurrence was observed in patients with mucosal cancer. In the present study, tumor length was a statistically significant prognostic factor for cause-specific survival (P = 0.018) and tumor depth tended toward statistical significance (P = 0.073). In 27 patientswith submucosal cancer, the tumor length was also statistically significant for the survival (P = 0.032). The 5-year cause-specific survival rates for the short tumor group and the long tumor groupwere 85.7%and 55.6%, respectively. On the other hand, the use of intraluminal brachytherapy had no significant effect on patient survival. Conclusion: Radiation therapy is very effective for early esophageal squamous cell carcinoma with tumor length less than 5 cm, but other treatment modalities, including chemoradiotherapy especially for inoperable patients, should be considered for submucosal cancer with a tumor length of 5 cm or more.
文摘Introduction. Squamous cell carcinoma is a malignant epithelial tumor of the skin, rarely observed in "black"skin. It often complicates an acquired or congenital pre-neoplastic dermatosis. We report on 80 cases of squamous cell carcinoma having occurred in black African patients from Senegal. Patients and methods. We retrospectively analyzed all the medical files of patients followed-up in the department for histologically confirmed squamous cell carcinoma from 1980 to 1999. Results. Eighty cases of carcinoma were collected. The mean age of the patients was of 47 years (range: 1 to 85) and the sex ratio was of 1.35 (46 men and 34 women). A pre-neoplastic dermatosis was identified in 65%of the patients. Acquired pre-neoplastic dermatosis was: heat burn scars (15 cases), chronic discoid lupus erythematosus (6 cases) and chronic phagedenic ulcer (4 cases). Pre-neoplastic genodermatoses were: albinism (6 cases), xeroderma pigmentosum (5 cases) and epidermodysplasia verruciformis (1 case). Lesions were multiple and cephalic in patients with genodermatosis. Death due to carcinoma occurred in 8 patients. Comments. This large series of squamous cell carcinoma emphasizes: the rarity of squamous cell carcinomas in black patients and the frequency of its occurrence on acquired pre-existing dermatosis. For many years phagedenic ulcers predominated. Our results show the regression of the latter and its increase on post-burn scars and chronic lupus erythematosus. Pre-neoplastic genodermatoses thatdeterminemultiplecancers,usuallylocatedonsun-exposed areas and occurring in young patients, are particularly severe.
文摘Based on the reduced morbidity seen in our retrospective study, we undertook a prospective, randomized trial to determine whether transposition of the sartorius muscle improves postoperative morbidity in women with squamous cell carcinoma of the vulva undergoing inguinal- femoral lymphadenectomy. Patients with squamous carcinoma of the vulva requiring inguinal- femoral lymphadenectomywere randomized to undergo sartorius transposition or not. All patients received perioperative antibiotics, DVT prophylaxis, and closed suction surgical site drainage. Outcomes assessed include wound cellulitis, wound breakdown, lymphocyst formation, lymphedema, and/or rehospitalization. Cohorts were compared using Fisher’ s exact test. Baseline characteristics were compared using Student’ s t test or Fischer’ s exact test as appropriate. Logistic regression was used to assess the impact of sartorius trans position, after adjusting for other factors. From June 1996 to December 2002, 61 patients underwent 99 inguinal- femoral lymphadenectomies, 28 with sartorius transposition, and 33 without. The mean (SD) age for controls and patients undergoing sartorius transpositionwas 63.5 (15.2) and 73.8 (13.7) years, respectively (P < 0.05). There were no statistically significant differences in BSA, tobacco use, co- morbid medical conditions, past surgical history, medication use, size of incision, duration of surgery, number of positive lymph nodes, pathologic stage, pathologic grade, pre- or postoperative hemoglobin, or length of hospitalization. Therewere no statistically significant differences in the incidence of wound cellulitis, wound breakdown, lymphedema, or rehospitalization. The incidence of lymphocyst formation was increased in the sartorius transposition group. After adjusting for age, however, the groups appeared similar. Sartorius transposition after inguinal- femoral lymphadenectomy does not reduce postoperative wound morbidity.
