Surgical oncology clinics of North America
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Approximately 141,000 patients will develop colorectal cancer each year and 45% will have positive lymph nodes, one of the most significant predictors of survival. Now there is evidence that systemic chemotherapy with fluorouracil (FU) and leucovorin, levamisole, or FU and leucovorin with decrease recurrence and increase survival for patients with Dukes' C colon cancer. In patients with Dukes' B or C rectal cancer, combined radiation and FU increase survival and decrease local and distal recurrence.
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Surg. Oncol. Clin. N. Am. · Apr 1997
Ductal carcinoma in situ. The success of breast conservation therapy: a shared experience of two single institutional nonrandomized prospective studies.
A combined database of 342 patients with DCIS treated by lumpectomy alone versus lumpectomy and radiation therapy with a median 82-month follow-up is summarized in this joint study. Reproducible subtype classification and common methods of mammographic-pathologic correlation and complete tissue processing are unique features of this database, and they permit outcome to be analyzed by pathologic subtype, size, and margine status. Striking differences are noted in local control rates analyzed by subtype, which were largely independent of irradiation (see Table 1). ⋯ Significant differences achieved by radiation therapy were demonstrable only for the smallest size group (15 mm or less) in the highgrade subtype (group III). Differences in local recurrence rates for low and intermediate subtypes (group I and II) based on radiation therapy could not be demonstrated within the three size categories used in the study. We conclude that although adequate margins are more difficult to achieve for larger or more extensive DCIS, size alone is not a prohibition to breast conservation.
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Indwelling central venous access catheters were first introduced into clinical practice about 20 years ago. Today these catheters are an indispensable part of the treatment provided to adult and pediatric oncology patients. This article discusses the indications and major complications of central venous catheters.
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Surg. Oncol. Clin. N. Am. · Jul 1995
ReviewInterventional radiology and cross sectional imaging in venous access.
The role of radiology and the interventional radiologist in the care of patients requiring long term venous access is expanding. This role includes multimodality imaging for anatomic evaluation, guided catheter placement or repositioning, and diagnosis and treatment of catheter occlusion or related venous thrombosis. Interventional procedures have been developed for relief of venous obstruction, repositioning of catheters, and placement of unconventional access devices.
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Surg. Oncol. Clin. N. Am. · Jul 1995
ReviewA review of peripherally inserted central venous catheters in oncology patients.
The use of semipermanent vascular access devices has become standard in the management of specific clinical populations. Recently, the use of peripherally inserted catheters has gained popularity owing to the relative ease of insertion and lower complication rates.