Risk Factor for Recurrence of Breast Cancer

The risk factors of recurrence following surgical treatment for patients with breast cancer were clinically evaluated on the basis of a result of clinical analysis. In this study, it is emphasized that special attention should focus on tissue CEA and DNA analysis. In conclusion, clinical uses of tissue positive CEA and aneuploid pattern in analysis of nuclear DNA content in cancer cells are of great value to forecast recurrence

Postoperative Complications and Mortality of the Patients with Esophagectomy for Esophageal Carcinoma

Between 1970 and 1989, 154 patients underwent esophagectomy for esophageal cancer in our department. One hundred and twenty-one patients underwent esophageal resection and reconstruction and 14 had esopahgectomy alone without reconstruction. There were 26 operative deaths within 30 days after operation. However, the mortality rate was 29.1% during the 1970 to 1979 period, and 10.1% after 1980. Predominant postoperative complications were anastomotic leak, pneumnia, sepsis and recurrent laryngeal nerve paralysis. The rates of postoperative complications during 1970 to 1970, was 67.3% and was 43.3% after 1980. The rate of anastomotic leak was 45.4% in the former years, but it improved to 26.6% in the later period. To prevent the postoperative complications, careful perioperative management of the patients are essential

Surgery for Tracheal Stenoses

On the basis of an analysis in the outcome of tracheal surgery, it proved useful for the relief of respiratory distress. As a result, we are confident that surgical management should be mandatory for tracheal stenoses, provided that the patient\u27s general condition is satisfactory with preoperatively meticulous cares. The incidence of occurring the risks of postoperative complications was relatively high in patients with malignant lesion. It seemd preferable to select a wide resection as far from the visible margin of the tumor as possible, in particular, in case of adenoid cystic caricnoma

Paget\u27s Disease of the Female Breast

Eight patients of Paget\u27s disease of the breast operated during 1969 and 1990 were studied. Four patients had Paget\u27s diseases confirmed to the nipple and remaining 4 patients had an associated palpable tumor. Seven patients had invasive intraductal carcinoma and only one had noninfiltrative ductal carcinoma. None of the patients without palpable mass had axillary lymph node metastasis, while three of four patients (75%) with palpable mass in the breast had axillary lymph node metastases. One patient of 4 without palpable mass died of lung cancer 19 years and 8 months after operation. Remaining 3 are alive and well 3 years, 4 years and 16 years following mastectomy. Two of 4 patients with palpable breast mass died of metastasis 6 months and 8 months after surgery. Remaining 2 are alive and well 7 months and 22 years following mastectomy

Recurrent Breast Cancer with Bone Metastasis

Twenty patients with bone metastasis following surgery for recurrent breast cancer were clinically evaluated in analysis of clinicopathologic aspect in comparison with those with metastases in other organ. It is more likely that bone metastasis occurs in younger patients as compared with other organ metastasis. However, there were no certain clinical patterns of patients with bone metastasis including the survival time, as compared with those with other organ metastasis. In this series, ER and PgR failed to measure and to elucidate the effect of hormore therapy because a subject includes parts of patients prior to development of ER and PgR measurement. In conclusion, there were no clinicopathologic features in patients with bone metastasis following surgical treatment of breast cancer except for occurrence in younger patients

Long-term Survivors after Pulmonary Resection for Bronchogenic Carcinoma

Surgical resection is the most useful modality of treatment for patients with lung cancer. However, two third of the patients who underwent pulmonary resection died within 5 years after operation due to recurrent diseases. This study reviewed long-term survivors (more than 10 years after lung resection) and examined the factors relating to prognosis and the quality of life of the patients after 10 years. Two-hundred and forty-nine patients underwent pulmonary resections for bronchogenic carcinoma in the First Department of Surgery of Nagasaki University Hospital between 1955 -and 1978. Among 237 who tolarated operations, 32 patients (13.5%) survived more than 10 years after pulmonary resections. There were 23 men and 9 women. Among the patients with stage I, 25/85 (29.4%) survived more than 10 years, while in the cases with Stage III, only 3/122 (2%) survived. There was no difference with survival rate between the patients with squamous cell carcinoma and those with adenocarnoma. Thirty patients underwent lobectomy and only two with pneumonectomy survived more than 10 years after surgery. Among 32 patients, 21 are alive and well without recurnce, 3 died of secondary primary lung cancer, one died of recurrent disease, and one died of gastic cancer. Most of the patients were free of respiratory symptoms after 10 years. The favorable factors contribuitng to long-term survival after pulmonary resection for the patients with lung cancer are small and early lesions (Stage I, T1, N0, N1 ), lobectomy, cell types of squamous cell carcinoma or adenocarcinoma, and ages under 70 years. However, secondary lung tumors would occur to the patients who survived more than 10 years after pulmonary resection, thus requiring continuous follow-up

Clinical Significance of Combined Resection with Tracheobronchial Trees for Advanced Esophageal Cancers

It was confirmed that combined resection of the trachea and the bronchus is feasible and available for advanced cancer patients on the basis of 9 patients of our clinical experience. However, meticulous postoperative cares are necessary for prevention of fatal outcome of postoperative complicatios. Anatomical drawback of tracheobronchoplastic operation is able to be overcome in combination with the procedure of omentopexy which facilitates neovascularity to the reconstructed trachea and bronchus

Surgery for Advanced Lung Cancer

Twenty-one patients with advanced lung cancer who underwent surgery were clinically reviewed on the basis of clinical experience at the First Department of Surgery, Nagasaki University School of Medicine. The surgical outcome was related to the intensity of surgical insult, which implied the grade of cancer progression. However, aggressive surgery is effective in a palliation of patient\u27s surffering regardless its time duration. It is emphasized that surgeons should be aware of establishment of safety operation and of elimination of the risk of cancer spreading during surgical manipulation to improve surgical outcome for advanced lung cancer