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Lower Recurrence Rate (lower + recurrence_rate)
Selected AbstractsAtypical fibroxanthoma/malignant fibrous histiocytomaDERMATOLOGIC THERAPY, Issue 6 2008Steven Marcet ABSTRACT:, Atypical fibroxanthoma (AFX) is an unusual spindle cell tumor occurring on actinically damaged skin of the head and neck. Clinically, it is often confused with basal cell carcinoma, squamous cell carcinoma, or even melanoma. Although initially thought to be a diagnosis of exclusion histologically, newer immunostains have helped in the identification of AFX. Mohs micrographic surgery has been utilized for the treatment due to its tissue sparing ability along with lower recurrence rate. [source] Mechanism of Action of Low Recurrence of Gastritis Caused by Helicobacter pylori with the Type II Urease B GeneHELICOBACTER, Issue 2 2004Md. Badruzzaman ABSTRACT Background., Low recurrence of gastritis is seen in patients infected with Helicobacter pylori carrying the type II urease B gene, compared with H. pylori carrying types I and III. The underlying mechanism has been studied in terms of the urease activity and interleukin (IL)-8 production capacity of different strains of H. pylori. Materials and Methods., Forty-five patients infected with different strains of H. pylori (type I; 15, type II; 15 and type III; 15) were enrolled in the study. H. pylori was isolated from gastric mucosa and cultured in the presence of urea at pH 5.5 to evaluate urease activity. The capacity of different strains of H. pylori to induce IL-8 mRNA and IL-8 from a human gastric cancer cell line and human peripheral blood mononuclear cells was evaluated. Results., The urease activity of type II H. pylori[523 ± 228 µg of ammonia/dl/108 colony-forming units (CFU)/ml] was significantly lower than that of type I (1355 ± 1369 µg of ammonia/dl/108 CFU/ml) and type III (1442 ± 2229 µg of ammonia/dl/108 CFU/ml) (p < .05). Gastric cancer cells cocultured with type II H. pylori produced lower levels of IL-8 mRNA compared with type I and type III H. pylori. The levels of IL-8 were also significantly lower in cultures induced by type II H. pylori compared with those induced by type I and type III H. pylori. Peripheral blood mononuclear cells also produced lower levels of IL-8 when cocultured with type II compared with type I H. pylori. Conclusions., These results indicate that both the lower level of urease activity and the low IL-8-inducing capacity of type II H. pylori might underlie the lower recurrence rate of gastritis caused by type II H. pylori. [source] Long-Term Results of Endonasal Sinus Surgery in Sinonasal PapillomasTHE LARYNGOSCOPE, Issue 9 2003Marcel Kraft MD Abstract Objective To assess the value of endonasal sinus surgery in the management of sinonasal papillomas. Study Design Retrospective study including 43 patients operated on for sinonasal papilloma in a long-term follow-up. Methods In 26 cases (60%) an endonasal approach, in eight cases (19%) an external approach, and in four cases (9%) a combined procedure was performed to remove these tumors. Five septal lesions (12%) were resected under direct vision. The original sections and charts of all patients were reviewed to assess clinical data. Follow-up information was available for 42 of our patients (98%) with a mean follow-up of 62 months. Results Histologic examination revealed 34 cases of inverted papilloma (79%), five cases of exophytic papilloma (12%), and four cases of columnar cell papilloma (9%). Malignancy occurred in 4 of 43 patients (9%), and recurrences developed in 8 of 42 patients (19%). Two of these recurrences happened after endoscopic sinus surgery (two inverted papillomas), three after lateral rhinotomy (three inverted papillomas), one after a combined procedure (one inverted papilloma), and two after simple resection (two exophytic papilloma). Conclusions In keeping with our experience, the endonasal endoscopic approach, often in combination with a medial maxillectomy, is favored for the treatment of sinonasal papilloma because of a lower recurrence rate and a better cosmetic result. In some larger tumors and lesions in difficult locations, better visualization can be obtained by a combined external and endonasal approach. [source] Excision of the Preauricular Sinus: A Comparison of Two Surgical TechniquesTHE LARYNGOSCOPE, Issue 2 2001Henry Chuen Kwong Lam FRCS Abstract Objectives To compare the long-term recurrence rate of the standard technique (simple sinectomy) and the supra-auricular approach (wide local excision) for the surgical management of preauricular sinuses. Study Design Retrospective cohort. Methods Fifty-four patients with a preauricular sinus excised between May 1986 and December 1996 were included in this study. All patients were categorized into one of two groups based on the type of surgery performed: the standard technique or the supra-auricular approach. The medical records were then reviewed and the latest information concerning the recurrence of a preauricular sinus were updated by phone interview. The recurrence rate of these two groups was statistically analyzed by the Fisher exact test. Results Forty-nine of 54 patients were successfully contacted with data updated and analyzed. The 32% recurrence rate of the standard excision (n = 25) was significantly higher than the 3.7% recurrence rate of the supra-auricular approach (n = 27; two-tailed test, P = .01). Conclusion The supra-auricular approach for excision of a preauricular sinus has a statistically lower recurrence rate in comparison to the standard technique. [source] HP10 LAPAROSCOPIC RESECTION OF SUBMUCOSAL GASTRIC LESIONS , THE WHANGAREI EXPERIENCEANZ JOURNAL OF SURGERY, Issue 2007J. Y. Yang Purpose To evaluate safety of laparoscopic resection of submucosal gastric lesions performed in Whangarei Based Hospital. Methodology From November 2002 to December 2006, 8 consecutive patients underwent the above mention surgery. (M : F = 5 : 3; Average age 63 [range, 43,83]). All patients underwent pre-operative gastroscopy. Wedge resections were performed for anterior wall lesions. (n = 3). Posterior wall lesions were resected via transgastric approach. (n = 4). Retroperitoneal resection was performed for the foregut duplication cyst. (n = 1). All except one lesion were resected using endoscopic GIA stapler. The medical records of the patients were reviewed retrospectively. Results All patients were successfully treated laparoscopically. No conversion to open surgery. Pathology included: Gastrointestinal-stromal tumor (GIST) (n = 5), Malignant leiomyosarcoma (n = 1), Ectopic pancreas (n = 1), and Foregut duplication cysts (n = 1). All achieved adequate negative surgical margin. Average operation time was 106.14 minutes. [Range, 75,150]. Average length of hospital stay was 3.42 days [range, 1,5]. Complication included one wound infection, and one pyloric stenosis. Average length of follow up was 10.96 months [range, 0.46,31.73]. No recurrence detected and all are still alive till date. Conclusion Laparoscopic resection of submucosal gastric lesions is a safe and appropriate alternative to open surgery. Its main advantage over open technique includes shorter length of hospital stay, lower recurrence rate and lower mortality rates. Surgical technique depends very much on tumor size and location. Outcome of the patients described from our centre is comparable to the others published till date. [source] Superficial papillary urothelial carcinomas in young and elderly patients: a comparative studyBJU INTERNATIONAL, Issue 3 2004Mario Migaldi OBJECTIVE To compare the clinicopathological and immunohistochemical findings of superficial papillary transitional cell carcinomas in ,young' and ,elderly' patients, as the natural history and prognosis of bladder tumours in young patients remains a matter of debate. PATIENTS AND METHODS Tumours from 50 patients with superficial urothelial tumours of the bladder diagnosed before 45 years old (,young' group, follow-up 25,119 months) were compared with 90 similar tumours developed in patients aged >55 years (,elderly', follow-up 24,102 months). All the patients had a transurethral resection with curative intent, and none had received any therapy before surgery. After surgery only patients diagnosed with pT1 tumours were treated by intravesical bacille Calmette-Guérin (BCG) instillations; all received intravesical BCG if there was a recurrence. The clinicopathological variables, recurrence and disease-free interval to recurrence were assessed. Proliferative activity (MIB-1) and expression of cell-cycle regulation proteins cyclin D1, p53 and p27kip1 were detected by immunohistochemistry in the tumours of both groups. RESULTS There were statistically significant differences in tumour grade, stage and occurrence between the ,young' and ,elderly' groups. The ,young' group had a longer disease-free interval to recurrence. Among the immunohistochemical markers analysed, only MIB-1 and cyclin D1 were associated with an increased risk of recurrence in the ,young' group (P < 0.04 and <0.01, respectively) in a univariate analysis. CONCLUSIONS Superficial papillary urothelial tumours of the bladder in ,young' patients had a better prognosis than those in the ,elderly' group, showing a lower grade and stage at diagnosis, and a lower recurrence rate. Proliferative activity and cyclin D1 expression levels were of prognostic significance for the risk of recurrence in these patients. [source] Right hepatectomy by the anterior method with liver hanging versus conventional approach for large hepatocellular carcinomasBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 7 2010T.-J. Wu Background: The aim was to compare short-term results of right hepatectomy using the anterior approach (AA) and liver hanging manoeuvre with the conventional approach (CA) for large hepatocellular carcinoma (HCC). Methods: This was a retrospective review of 71 consecutive patients with HCC at least 5 cm in diameter who underwent curative right hepatectomy using either the AA with the liver hanging manoeuvre (33) or the CA (38) between January 2004 and December 2008. Clinical data, operative results and survival outcomes were analysed. Results: The groups had similar clinical, laboratory and pathological parameters. The AA group had larger tumours than the CA group (P = 0·039), but comparable grade and stage distribution. The operative results were similar except for an increased blood transfusion requirement with the conventional procedure (P = 0·001). The AA group had a lower recurrence rate (P = 0·003) and better disease-free survival (DFS) (P = 0·001) than the CA group, but overall survival rates were not significantly different (P = 0·091). Presence of tumour encapsulation, absence of tumour microvascular invasion and AA were predictive of DFS, whereas tumour stage was the only independent predictor of overall survival. Conclusion: The AA right hepatectomy with liver hanging manoeuvre for large HCC is associated with reduced blood transfusion requirement and lower recurrence rates in the short term. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Treatment effects, disease recurrence, and survival in obese women with early endometrial carcinoma,CANCER, Issue 12 2006A Gynecologic Oncology Group study Abstract BACKGROUND. The objective was to examine whether rates of disease recurrence, treatment-related adverse effects, and survival differed between obese or morbidly obese and nonobese patients. METHODS. Data from patients who participated in a randomized trial of surgery with or without adjuvant radiation therapy were retrospectively reviewed. RESULTS. Body mass index (BMI) data were available for 380 patients, of whom 24% were overweight (BMI, 25,29.9), 41% were obese (BMI, 30,39.9), and 12% were morbidly obese (BMI, ,40). BMI did not significantly differ based on age, performance status, histology, tumor grade, myometrial invasion, or lymphovascular-space involvement. BMI > 30 was more common in African Americans (73%) than non-African Americans (50%). Patients with a BMI , 40 compared with BMI < 30 (hazards ratio [HR], 0.42; 95% confidence interval [CI], 0.09,1.84; P = .246) did not have lower recurrence rates. Compared with BMI < 30, there was no significant difference in survival in patients with BMI 30,39.9 (HR, 1.48; 95% CI, 0.82,2.70; P = .196); however, there was evidence for decreased survival in patients with BMI , 40 (HR, 2.77; 95% CI, 1.21,6.36; P = .016). Unadjusted and adjusted BMI hazards ratios for African Americans versus non-African Americans in the current study differed, thus suggesting a confounding effect of BMI on race. Eight (67%) of 12 deaths among 45 morbidly obese patients were from noncancerous causes. For patients who received adjuvant radiation therapy, increased BMI was significantly associated with less gastrointestinal (R, ,0.22; P = .003) and more cutaneous (R, 0.17; P = .019) toxicities. RESULTS. In the current study, obesity was associated with higher mortality from causes other than endometrial cancer but not disease recurrence. Increased BMI was also associated with more cutaneous and less gastrointestinal toxicity in patients who received adjuvant radiation therapy. Future recommendations include lifestyle intervention trials to improve survival in obese endometrial cancer patients. Cancer 2006. © 2006 American Cancer Society. [source] | ||||||||||