ABSTRACT
BACKGROUND: Some authors have stated the undesirability of axillary lymph node dissections for very small breast cancers, because so few of their patients have lymph node metastases (3% for T1a lesions in one series). METHODS: Of 6,308 breast cancer cases reviewed from three large urban hospitals 3,077 single primary cases with both axillary dissection and accurate tumor measurements were statistically analyzed. RESULTS: For T1a lesions we found axillary metastases to be four times higher (12%) than others have reported. For each tumor size there was a statistically significant difference in the percentage of axillary metastases. There was also a statistically significant difference in the breast cancer-specific survival of patients with different tumor sizes (n = 3,077) at the 3-year, 5-year, 7-year, and 10-year periods. CONCLUSION: These results justify axillary node dissections even for very small invasive cancers of the breast, particularly for invasive ductal histology.
Subject(s)
Breast Neoplasms/surgery , Lymph Node Excision , Adolescent , Adult , Aged , Aged, 80 and over , Analysis of Variance , Axilla , Breast Neoplasms/mortality , Breast Neoplasms/pathology , Female , Humans , Lymphatic Metastasis , Middle Aged , Neoplasm Staging , Survival RateABSTRACT
A retrospective study compares the success rates of surgical treatment of cancer of the pancreas in large community hospitals. Although none of the surgeons averaged as many as two pancreaticoduodenal resections per year for the period of this study, their results compared well with other published series except for a few centers and surgeons who did a very high volume of such resections. Results of the study indicate that well trained surgeons in well staffed and well equipped community hospitals can provide acceptable results in pancreaticoduodenectomies for cancer of the pancreas.
Subject(s)
Hospitals, Community , Pancreas/surgery , Pancreatic Neoplasms/surgery , Adult , Aged , Cohort Studies , Female , Humans , Male , Middle Aged , Pancreas/pathology , Pancreatic Neoplasms/mortality , Pancreatic Neoplasms/pathology , Retrospective Studies , Survival RateABSTRACT
Plasmids carrying type I or II sulfonamide-resistance (Sur) genes were evaluated for their effect on synergy between trimethoprim (Tmp) and sulfamethoxyzole (Smx) in E. coli. Strain J53 containing each of three plasmids (R1, pSa, and R388) with the type I Sur gene displayed a synergistic response to Tmp/Smx; strain LE392 containing a plasmid (RSF1010) with the type II Sur gene displayed no synergy. The difference in synergy between type I and type II Sur genes might be explained by the difference in amount of resistant enzyme produced.
Subject(s)
Escherichia coli/genetics , Genes, Bacterial/drug effects , Sulfonamides/metabolism , Trimethoprim, Sulfamethoxazole Drug Combination/pharmacology , Drug Synergism , Plasmids , Trimethoprim Resistance/geneticsABSTRACT
A very unusual case of an apparent primary clear cell adenocarcinoma of the vulva in a 57-year-old female is presented. The carcinoma arose in an area of endometriosis within the canal of Nuck in the superior aspect of the right labium majus. Smooth muscle fibers presumably representing remnants of the extrapelvic round ligament were found associated with the endometriosis. Of interest is the fact that the patient underwent right herniorrhaphy 9 years earlier. Although several cases of primary adenocarcinoma arising within the vulva have been reported, none has arisen in areas of endometriosis within the canal of Nuck. No case in the literature of a primary clear cell adenocarcinoma arising from endometriosis in the canal of Nuck and in association with the extrapelvic portion of the round ligament could be found.
