Journal of the Egyptian National Cancer Institute
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J Egypt Natl Canc Inst · Sep 2006
Ipsilateral in-breast tumor relapse after breast conservation therapy: true recurrence versus new primary tumor.
Ipsilateral breast tumor relapse (IBTR) occurs in approximately 8-20% of women 10 years after breast conservation therapy (BCT). The aim of this study is to classify ipsilateral breast tumor relapses in patients treated with conservative surgery and radiation therapy as true recurrences or new primary and to show the clinical significance of classification into these two types of recurrences. ⋯ It appears that a significant portion of patients who experience ipsilateral breast tumor relapse following conservative surgery and radiation therapy have new primary tumors as opposed to true recurrences. Patients with a new primary had better survival rates than those with true recurrence. Distinguishing new primary breast carcinoma from local disease recurrence may have importance in therapeutic decisions and chemoprevention strategies.
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J Egypt Natl Canc Inst · Sep 2006
Randomized Controlled TrialLocally advanced rectal carcinoma: preoperative radiotherapy versus postoperative chemoradiation, 10-year follow-up results of a randomized clinical study.
A prospective study was designed to randomize locally advanced rectal carcinoma patients between either preoperative radiotherapy (+/- postoperative chemotherapy) or postoperative adjuvant chemoradiation. Two end points were evaluated, local recurrence and survival, aiming at defining prognostic parameters that can help in the choice of the optimum treatment modality. ⋯ This work showed equal results for DFS and OS rates between preoperative and postoperative radiation therapy with the same acceptable acute and late radiation toxicity. High dose preoperative irradiation did not cause any significant increase in acute or late radiation induced reactions, delay in wound healing or increased postoperative morbidity when compared to postoperative adjuvant radiochemotherapy. Duke' s stage and response to preoperative irradiation proved to be of significance regarding DFS, while compliance to systemic therapy was of significance regarding both OS and DFS.
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J Egypt Natl Canc Inst · Jun 2006
Immediate breast reconstruction with expander assisted latissimus dorsi flap after skin sparing mastectomy.
The latissimus dorsi myocutaneous flap (LDMF) used to be the standard practice for breast reconstruction; however, with the increased use of tissue expanders and the development of the transverse rectus-abdominis myocutaneous flap for autologous tissue breast reconstruction, its use has decreased. To reassess the role of the LDMF in breast reconstruction, a prospective study was performed to evaluate women who had a skin sparing mastectomy followed by immediate reconstruction with a latissimus dorsi flap and tissue expander implant. ⋯ Skin sparing mastectomy and immediate breast reconstruction is an oncologically safe technique. The use of latissimus dorsi myocutaneous flap with tissue expansion has proved to be an effective and aesthetic method of immediate breast reconstruction after skin sparing mastectomy.
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J Egypt Natl Canc Inst · Mar 2006
Rhabdomyosarcoma: the experience of the pediatric unit of Kasr El-Aini Center of Radiation Oncology and Nuclear Medicine (NEMROCK) (from January 1992 to January 2001).
Our present study is a retrospective analysis of the treatment results of new rhabdomyosarcoma pediatric patients who had attended the pediatric unit clinic of Kasr El-Aini Center of Radiation Oncology and Nuclear Medicine (NEMROCK) from January 1992 to January 2001). ⋯ Despite the advances in the therapy of rhabdomyosarcoma. Nearly 30% of the pediatric cases with rhabdomyosarcoma experience progressive or relapsing disease, which has a fatal end. The factors determining the 5-year survival after relapse at the time of initial diagnosis include histological subtype, and disease cluster. These findings will form the basis of a multi-institutional risk adapted relapse protocol for childhood rhabdomyosarcoma patients.
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J Egypt Natl Canc Inst · Mar 2006
The reliability of pectoralis major myocutaneous flap in head and neck reconstruction.
The pectoralis major myocutaneous pedicle flap (PMMPF) has been considered to be the "workhorse" of pedicled flaps in head and neck reconstruction. Several series of PMMPF procedures in head and neck reconstruction have been reported in the literature. Even with the worldwide use of free flaps, the flap is still considered the mainstay head and neck reconstructive procedures in many centers. However, the flap is usually associated with a high incidence of complications in addition to its large bulk compared with the free fasciocutaneous flaps. Also the final functional and the aesthetic results are not comparable to free flaps head and neck reconstruction. ⋯ Although the PMMPF is a versatile flap in head and neck reconstruction, being in the proximity of the region with good reach to different areas of the face, oral cavity, and the pharynx; the flap is fraught with a high complication rate. The wide use and the reliability of free flaps in head and neck reconstruction have superseded the use of the PMMPF flap in comparable circumstances. However, the flap still has a place in head and neck reconstruction, particularly after resection of locally advanced tumours. Also the flap can be still used as a salvage procedure after free flaps failure or when there is a shortage of the microsurgery facility.