ABSTRACT
PURPOSE: The purpose of this study was to compare the efficacy of curative emergency surgery for complicated colon cancer in terms of tumor recurrence and survival compared with that of elective surgery. METHODS: A total of 238 primary surgeries for colon cancer were performed. All patients were deemed to have undergone a curative resection. Patients were classified into an emergency surgery group for complicated colon cancers (n=40) and an elective surgery group for uncomplicated colon cancers (n=198). RESULTS: Emergency colonic cancers present at a more advanced stage (P=0.002). The postoperative mortality rate in the emergency group was significantly higher than it was in the elective group (15.0% vs. 2.5%, P= 0.004). There were differences between the two groups in tumor recurrence (32.5% vs. 13.1%, P=0.003), overall survival (52.5% vs. 71.7%, P=0.017), and disease-free survival (50.0% vs. 69.7%, P=0.016). However, after the patients were stratified according to tumor stage, no statistical differences were observed. CONCLUSIONS: When compared with uncomplicated colon cancers, complicated colon cancers present at a more advanced stage with a higher postoperative mortality and an overall worse prognosis. However, the difference decreases when patients are stratified according to the tumor stage. The negative prognostic efficacy of emergency surgery for complicated colon cancers appears to be confined to the perioperative period. Despite the more advanced stage of tumors in patients undergoing emergency surgery, the aim of the surgeon should be to offer a curative resection for better survival, if possible.
Subject(s)
Humans , Colon , Colonic Neoplasms , Disease-Free Survival , Emergencies , Mortality , Perioperative Period , Prognosis , RecurrenceABSTRACT
The salivary duct carcinoma(Speichelgangcarcinoma) was first applied by Kleinsasser et al7) to a group of carcinomas of the salivary glands that histologically resembled ductal carcinoma of the breast. The criteria for the diagnosis of salivary duct carcinoma are circumscribed epithelial nests, having a papillary, cribriform, and/or solid architecture coupled with central necrosis. The neoplasm occurs beyond the age of 50(median 63 years). Its biologic behavior is highly aggressive; the metastatic and tumor-related death rates were 75% and 73%, respectively. All surviving patients have been treated with combined parotidectomy and radiotherapy. The authors recently experienced a case of salivary duct carcinoma in right parotid gland which was treated with total parotidectomy and postoperative radiotherapy and report with review of literature.
Subject(s)
Humans , Breast , Carcinoma, Ductal , Diagnosis , Mortality , Necrosis , Parotid Gland , Radiotherapy , Salivary Ducts , Salivary GlandsABSTRACT
OBJECTIVE: Zinc and copper are the second and third most abundant trace elements following iron in the human body. Zinc and copper have important effects on humoral and cell-mediated immunity. In patients with rheumatoid arthritis, it has been reported that serum zinc level is decreased and seurm copper level increased. But no reports are available for the trace element level of hair in patients with rheumatoid arthritis. We studied to investigate the significance of trace element level of hair in rheumatoid arthritis patients, particularly its relation to disease activity. METHODS: The trace element level of hair was estimated in 50 patients with rheumatoid arthritis and 22 osteoarthritis patients by inductively coupled plasma atomic emission spectrometry and was investigate the correlation to various disease activity indices of rheumatoid arthritis. RESULTS:The results were as follows: 1) There was no significant difference in either the zinc or copper level in hair between patients with rheumatoid arthritis and osteoarthritis. 2) No correlation was observed between the zinc or copper level in hair and age or disease duration for rheumatoid arthritis patients. 3) Zinc and copper levels of hair did not correlate with various indices of disease activity in rheumatoid arthritis patients. CONCLUSIONS: Zinc and copper levels of hair in rheumatoid arthritis patients were not different from those of osteoarthritis and did not correlate with disease activity indices. Studies on the effect of antirheumatic drug therapy on trace element level of hair are necessary.
