Journal of the American College of Surgeons
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Comparative Study
Pathologic response to induction chemotherapy in locally advanced carcinoma of the breast: a determinant of outcome.
The prognosis for patients with locally advanced carcinoma of the breast remains poor. This study examines the pathologic evidence of response of the mammary tumor and axillary nodes after preoperative chemotherapy. We sought to determine if there was a relationship between the histologic response and clinical outcome. ⋯ These results indicate that patients whose tumors have the best pathologic response to induction chemotherapy experience the best outcome.
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We have previously shown high morbidity and mortality rates in patients with acquired immunodeficiency syndrome (AIDS) who require emergency abdominal operations. In a larger series of patients, we have investigated the reasons for these findings and have hypothesized that they are primarily the result of starvation and decreased resistance to infection. ⋯ Patients who meet the criteria for the diagnosis of AIDS have increased morbidity and mortality rates after emergency abdominal operations. This, however, should not exclude these patients from operation when it is indicated because many will survive and benefit from the operative procedure. Attention to nutritional support and the early diagnosis and treatment of associated infectious complications may result in decreased morbidity and mortality rates subsequent to the emergency abdominal operations.
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Case Reports
Techniques in the composite reconstruction of extensive thoracoabdominal tumor resections.
This report illustrates the unique problems of reconstructing thoracoabdominal wall defects coexisting with diaphragmatic defects. ⋯ Our report confirms the principle that, with modern thoracic and plastic operative techniques, the extent of tumor resection should not be compromised because of concern over the ability to reconstruct the defect.