The efficacy of radiotherapy as postoperative treatment for desmoid tumors.

PURPOSE: The purpose of this study was to determine if radiotherapy is a beneficial adjuvant treatment after desmoid tumor resection. METHODS AND MATERIALS: A retrospective analysis was performed on 54 patients who underwent surgery without prior radiation at our institution between 1982 and 1998 to remove a desmoid tumor. Thirty-five patients had adjuvant radiation therapy after surgery, and 19 patients had surgery alone without immediate postoperative radiation. Sixteen of the 35 patients who underwent immediate postoperative radiation treatment had at least one prior resection before reoperation at our institution. Recurrence was defined as radiographic increase in tumor size after treatment. Follow-up interval (mean 39 months) and duration of local control were measured from the date of surgery at our institution. Potential prognostic factors for time to tumor progression were analyzed. RESULTS: Adjuvant treatment with radiation was the only significant prognostic factor for local control. The five-year actuarial local control rate was 81% for the 35 patients who underwent radiation in addition to surgery, compared to 53% for the 19 patients who underwent surgery alone (p = 0.018). For the patients who did not receive adjuvant radiation, only younger age at the time of surgery was associated with increased risk of failure (p = 0.035). Gross or microscopic margin status and number of prior operations were not detected as prognostic for local failure. For patients who did receive postoperative radiation, only abdominal location was associated with increased risk of failure (p = 0.0097). CONCLUSION: Radiation treatment as an adjuvant to surgery improved local control over surgery alone. Multiple operations before adjuvant radiation did not decrease the probability of subsequent tumor control. Radiation should be considered as adjuvant therapy to surgery if repeated surgery for a recurrent tumor would be complicated by a significant risk of morbidity.

[Viable bacterial counts by agar-droplet technique (author's transl)]. / Die kulturelle Keimzahlbestimmung im Agartropfen

This paper deals with 1) Analysis of the agar droplet technique for viable bacterial counts with respect to a new technical aid (Colworth DROPLETTETM); 2) Comparison of the results obtained from two conventional plate count techniques and the agar-droplet method; 3) Examples for the practical use of this new technique. As a helpful aid for the agar-droplet technique there now exists an apparatus (Colworth DROPLETTETM, Fig.1) which facilitates dilution and dispension of bacteria containing agar, as well as counting of colonies grown in agar droplets. Precision and reproducibility of the diluter/dispenser was found to be within the limits of the usual sampling error (Tab.1, Fig. 2, Fig. 3). The visibility of colonies grown in agar droplets is improved by a ten-fold enlargement on the ground glass screen of the viewer (Fig. 7). In order to obtain droplets of equal size a standardised dropping-technique is required. The fluid agar must not exceed a constant temperature of 50 degrees C as otherwise four of the five species tested (Staph. aureus, E. coli, Kl. aerogenes, Ps. aeruginosa and Enterococci) were significantly reduced in number during the manipulation (Fig. 4, Fig. 5). Agar droplet technique, flooding technique and pour plates gave similar results with gram-positive and gram-negative bacteria from medical routine materials. Comparing the arithmetic means, viable counts of Staph. aureus were slightly higher from pour plates while E. coli and Kl. aerogenes gave the highest counts on flooded plates (Tab. 8-11). All of the three methods produced relatively too low counts when the number of bacteria per sample surmounted 300. Counts below 10 allow only a very poor estimation of the actual number of bacteria (Tab. 12). The variability of droplet counts with bacterial numbers higher than 25 was less then the one of corresponding plate counts (Tab. 14-16). Significant savings in materials, labour and incubator space are made with the agar droplet method. As examples for the practical use of the new method the results of the kinetics of thermally inactivated as well as of growing bacteria are presented.