Many theoretical and experimental models indicate that androgen receptors can play an important role as prognostic factors in breast cancer. The aim of this study was to evaluate the correlations between the presence of androgen receptors on cancer cells and other selected prognostic and predictive factors with established clinical significance in women with breast cancer after radical surgical treatment. 488 adult females were included in the study, who underwent primary radical surgery for breast cancer. 428 patients (87.7%) had Patey's conservative radical mastectomy and 60 (12.3%) Halsted's radical mastectomy. The mean age at operation was 54.3, ranging from 32 to 79. The mean length of hospitalization was 7.2 days for the patients after Patey's mastectomy and 9.8 days for those after Halsted's mastectomy. The androgen receptor is the most frequently detected steroid receptor on breast cancer cells. Therapeutic efficacy of adjuvant hormone therapy was higher in the group of androgen receptor-positive patients than in androgen receptor-negative ones. The prognosis for androgen receptor-positive patients who underwent adjuvant hormone therapy was better than for those androgen receptor-positive patients who did not receive hormone therapy after primary radical surgery for breast cancer. Assessment of androgen receptor levels on cancer cells should become a routine procedure with patients undergoing primary radical surgery for breast cancer, as it seems to be an important predictive factor.
This paper presents the life and achievements of Professor Jan Mikulicz-Radecki and his contribution to European and world surgery. He was born in 1850. Four periods can be distinguished in his surgical career: (1) Vienna period, 1875-82, when he worked by the side of the great Theodor Billroth: he introduced a number of new diagnostic and operative techniques, aseptic and antiseptic procedures, published research papers. He made the first endoscope for examining the esophagus and stomach. (2) Cracow period, 1882-87, when he was head of the Department of Surgery: he inaugurated his work with a lecture in Polish, which started: Gentlemen, I have been accused that I do not know the Polish language--which is my mother tongue to me as well as to any of you. He published papers on the use of iodophorm for healing wounds, was the first surgeon who sutured a perforated gastric ulcer (1885) and invented pyloroplasty (1887), nowadays called Heinecke-Mikulicz pyloroplasty. (3) Konigsberg period, 1887-90: he improved the technique of gastric resection, worked on surgery for peptic ulcer and advocated aseptic and antiseptic procedures. (4) Wroclaw (Breslau) period, 1890- 1905: Mikulicz was appointed head of a newly founded Surgical Department. He rebuilt it and designed one of the largest and most modern operating theaters in Europe that time. He introduced silk gloves for operations for the first time in the world. In 1892 he described bilateral swelling of salivary and lacrimal glands, called Mikulicz's syndrome; in 1902 he published his experience with two-stage colon resection; and in 1904 he described ostitis fibrosa cystica juvenilis. Called "a king in the kingdom of surgeons", he was one of the fathers of the world's modern surgery; having a brilliant surgical mind, he was a pioneer of many new operations and an inventor of surgical tools, permanently assimilated in the world's surgery.
Abstract:The prognosis in patients with pancreatic cancer is poor and some authors describe it as a lethal disease. At the time of diagnosis only 14% of patients could be surgically treated and up to 30% of them die within 12 months. Therefore, further clinical investigations on preoperative patient qualification are needed. A total of 81 patients were included into the study. The CA 19-9 concentration was measured before surgery by an automated, commercially available enzyme immunoassay in Axsym analyzer (Abott Diagnostics Laboratory). A value of 37 U/ml was used as the upper limit of normal levels. Tumors were staged according to the Union Against Cancer (UICC) of 2004 and graded during the histological evaluation according to the G0-G4 scale. All patients were monitored every three month via outpatient clinic visits. In the case of missing visit we contacted the families to establish the cause. We assessed perioperative, 12 month, 2 year and 5 year survival. Twelve moth, 2 year and 5 year survival were assessed in the whole studied population and in the group of patients with the exception of these who died during the perioperative period. The total five year survival was 6%. The median time of survival was 467 days (range: 163 -586 days). The perioperative period was survived by 91.4% patients, 12 months were survived by 71.6% patients, 2 years were survived by 35.8% patients, 5 years were survived by 6.2% patients. The serum Ca 19-9 level was above the normal limit in 80.5% patients. ROC curve analysis revealed that CA 19-9 level of more than 106 U/ml was linked to 2 year survival with 79.3% sensitivity and 74.5% specificity. Preoperative level of CA 19-9 below 106U/ml represents a predictive factor of 2-and 5-year survival, independent of other factors, such as lower size of the tumor, absence of metastases to lymph nodes, female gender of patients.After exclusion of the patients who died in the perioperative period, no relationship could have been disclosed between preoperative CA 19-9 levels and one year survival. The observation points to the chance that patients with higher levels of CA 19-9 harbour micrometastases, the development of which is sufficiently slow to allow for a one-year survival of the patients but which increase the risk of death after two and five years
The aim of the study. Retrospective analysis of indications for splenectomy in hematological diseases, positive effect of this operation and correlations between objective prognostic factors and good response to splenectomy in patients with different hematological indications for splenectomy. Material and methods. 98 adult patients with hematological disorders, who were splenectomised in the years 1994 -2004. We evaluated the effects of splenectomy in patients with hematological diseases as defined by patient documentation from the 2 nd Department of General and Oncological Surgery, Department of Hematology and Hematological Ambulance and the questionnaires that patients completed by themselves. Results. The beneficial effect of splenectomy was observed in the majority of cases of idiopathic thrombocytopenic purpura (41 of 53 patients), acquired hemolytic anemia (2 of 3 patients) and hereditary spherocytosis (8 of 9 patients). Surgery can provide a high frequency of durable response for adult patients with benign hematological disorders. In malignant hematological diseases, splenectomy eliminates consequences of hypersplenism or splenomegaly. Splenectomy in patients with malignant hematological disorders can improve their condition and relieve symptoms of hypersplenism and splenomegaly to improve their quality of life. There were early complications in 11 patients (11.3%). Mortality was 2%. Late complications appeared in 24 patients out of 96 patients, who survived the perioperative period. The most common late complication was moderate respiratory infections. Conclusions. Splenectomy is the most common operation in patients with hematological disorders. Indications for splenectomy have been hindered by the lack of any objective prognostic factors of good postoperative response. Nevertheless, the effect of splenectomy is positive in many patients with benign and malignant hematological diseases. Key words: splenectomy, hematological diseases Splenectomy is the most common surgical procedure in patients with hematological disorders. In many hematological conditions, the physiological and pathological (hypersplenism) function of the spleen is regulated by the occurrence of numerous clinical symptoms. As a result, the removal of the above-mentioned organ should eliminate the basic chain link of the pathogenetic process. However, in some patients, splenectomy does not promote regression of clinical symptoms. Thus, the basic problem in splenic surgery is associated with the absence of indices, which would predict the distant effects of splenectomy.The aim of this study was to retrospectively determine the indications for splenectomy and its efficacy in adult patients with hematological disorders, as well as the influence of certain objective factors on the therapeutic effect of splenectomy.
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