The utility of ICG fluorescence for sentinel lymph node identification in head and neck melanoma.

Purpose: Perform an evidence-based review to determine the utility of indocyanine green fluorescence (ICG) to detect sentinel lymph nodes (SLN) in patients with head and neck melanoma compared to blue dye or radiocolloid injection (RI).

Materials And Methods: A systematic review of the literature was performed to identify patients with head and neck melanoma managed with ICG fluorescence. PubMed, Embase, and Cochrane Library databases were searched.

Metabolomic identification of diagnostic serum-based biomarkers for advanced stage melanoma.

Introduction: Melanoma is a highly aggressive malignancy and is currently one of the fastest growing cancers worldwide. While early stage (I and II) disease is highly curable with excellent prognosis, mortality rates rise dramatically after distant spread. We sought to identify differences in the metabolome of melanoma patients to further elucidate the pathophysiology of melanoma and identify potential biomarkers to aid in earlier detection of recurrence.

Using global gene expression to discriminate thin melanomas with poor outcomes.

Most melanomas present as thin lesions (≤1.0 mm) with a good prognosis; however, a small percentage of patients with thin lesions experience recurrence or metastasis. The aim of our study was to identify a distinct pattern of gene expression within thin melanomas known to have eventually metastasized to regional lymph nodes or distant sites compared with those that followed the typical course with good response to wide local excision alone.

Gene expression differences predict treatment outcome of merkel cell carcinoma patients.

Due to the rarity of Merkel cell carcinoma (MCC), prospective clinical trials have not been practical. This study aimed to identify biomarkers with prognostic significance. While sixty-two patients were identified who were treated for MCC at our institution, only seventeen patients had adequate formalin-fixed paraffin-embedded archival tissue and followup to be included in the study.

An analysis of fine needle aspiration versus core needle biopsy in clinically palpable breast lesions: a report on the predictive values and a cost comparison.

Background: Although fine-needle aspiration (FNA) is an established tool in the biopsy of breast masses, there has been a trend toward using core-needle biopsy (CNB). The aim of this study was to determine whether FNA has comparable predictive value with CNB and whether FNA is more cost effective.

Methods: A retrospective review was conducted on 162 patients who underwent either FNA or CNB of palpable breast lesions and had histologic confirmation with surgical biopsy in calendar year 2005.

Adenocarcinoma of the pancreatic head: a community teaching hospital's experience from 1982 to 1992.

The treatment of adenocarcinoma of the pancreatic head remains variable, with multiple therapeutic options including surgery, biliary stenting, chemotherapy, and radiation therapy. We retrospectively reviewed our experience from 1982 through 1992, which included 160 patients with this diagnosis, evaluating their treatments and outcomes. There were 66 males and 94 females, with a mean age of 70+/-11 years.

T1a and T1b breast cancer: a twelve-year experience.

To understand the prevalence of axillary node metastasis and survival of patients with T1a and T1b breast cancers, we reviewed the experience at a large community hospital. All patients in the William Beaumont Hospital tumor registry with breast cancer treated between January 1983 and November 1995 were evaluated for tumor size, age, cell type, and the presence or absence of axillary node disease. Long-term survival was evaluated in patients treated between 1983 and 1992.

The impact of temporary iodine-125 interstitial implant boost in the primary management of squamous cell carcinoma of the oropharynx.

Background: To define the impact of interstitial boost of the oropharynx on local control and complications using iodine-125 (I-125) brachytherapy.

Methods: Between October 1986 and September 1991, 19 patients with cancer of the oropharynx received treatment at William Beaumont Hospital. Primary tumors consisted of 13 base of tongue, 4 tonsillar, and 2 pharyngeal wall lesions.

Excellent functional outcome in patients with squamous cell carcinoma of the base of tongue treated with external irradiation and interstitial iodine 125 boost.

Background: Local control, functional outcome, and complications in patients with carcinoma of the base of tongue (BOT) were analyzed to assess the impact of interstitial implant boost with I-125 seeds.

Methods: Between December 1986 and May 1995, 16 patients with squamous cell carcinoma of the BOT received treatment at the William Beaumont Hospital and 4 received treatment at the Northern Virginia Cancer Center. The primary tumor classification for this group consisted of T1/T2-11 patients, T3/T4-9 patients.

Recurrent laryngeal nerve palsy secondary to massive venous thrombosis.

Retrospective review of all patients with recurrent laryngeal nerve palsy seen at a comprehensive cancer centre over a 30 month period has revealed three patients with this diagnosis apparently related to massive venous thrombosis. All three patients had an underlying diagnosis of malignancy (two colon, one breast) and an indwelling central venous access device with its tip in the superior vena cava. Direct laryngoscopy was otherwise normal in all patients, and two had normal CT scans of the neck and mediastinum.

Complications following reconstruction with the pectoralis major myocutaneous flap: the effect of prior radiation therapy.

Over the past 5 years, 40 patients with head and neck cancer underwent pectoralis major myocutaneous flap (PMMF) reconstruction following radical ablative surgery. Twenty-three patients received prior radiation therapy (55 to 70.2 Gy), while 17 patients had no radiation preoperatively.

Comparison of infections in Hickman and implanted port catheters in adult solid tumor patients.

Long-term therapy of oncology patients has been facilitated by permanent indwelling central venous catheters, but catheter-related infections remain a serious complication of their use. Using a retrospective matched cohort design, we compared the risk of catheter-related infection in 47 adult solid tumor patients with right atrial Hickman catheters and 94 patients with totally implanted port catheters. Patients were matched for primary solid tumor, presence of metastases, age, gender, and date of catheter insertion.

Risk factors for immediate prosthetic postmastectomy reconstruction.

The charts of 44 women who underwent 47 immediate postmastectomy prosthetic breast reconstructions (IPMPBR) with subpectoral prostheses (long-term implant, long-term expandable implant or tissue expanders followed by long-term prosthetic placement) were retrospectively reviewed. Follow-up was from 3 to 49 months (median 18 months). Patient ages ranged from 31 to 77 years (median 42) but 82 per cent were under 60 years old.

Development of lung metastases after curative intraperitoneal chemotherapy in a rat colon cancer model.

A model of colon peritoneal carcinomatosis was developed by injecting 5 x 10(7) viable tumor cells intraperitoneally into Fisher 344 rats. All 40 control rats developed bulky abdominal tumor with ascites and died of peritoneal carcinomatosis and bowel obstruction (median survival 5 weeks). One day after tumor implantation, treatment group rats received a single intraperitoneal injection of single agent or combination chemotherapy.

Delayed breast abscesses after lumpectomy and radiation therapy.

The incidence of delayed breast abscess as a complication following the treatment of breast cancer has not been reported. A retrospective review of 112 patients (pts) undergoing lumpectomy and radiation therapy (RT) in our institution revealed a six per cent incidence of delayed breast abscess (range 1.5-8 months, median 5 months).

CT-guided needle localization for intraoperative biopsy of the head and neck.

Needle-localized intraoperative biopsy was first described for the nonpalpable breast mass using mammography for needle placement. This technique can be adapted by substituting CT (or MRI) for mammography. It can be a valuable tool in localizing the nonpalpable areas of concern in the head and neck, especially when the location is obscure or the patient has undergone previous radiation and/or surgical therapy.

Recurrent typhlitis. A disease resulting from aggressive chemotherapy.

Neutropenic typhlitis is a frequently fatal disease most commonly reported in leukemics. The authors have treated eight such patients over the last 18 months. All patients had abdominal pain and sepsis during chemotherapy-induced neutropenia.

Is percutaneous nephrostomy for hydronephrosis appropriate in patients with advanced cancer?

Twenty patients with advanced pelvic malignancy and secondary hydronephrosis underwent percutaneous nephrostomy between July 1982 and October 1986. Improvement in renal function occurred in 17 patients (85 percent), and survival ranged from 4 days to 2 years. Median survival was 13 weeks, and 55 percent of the patients required multiple hospitalizations for urosepsis.

Noncorrelation of the expression of the c-myc oncogene in colorectal carcinoma with recurrence of disease or patient survival.

Our previous work has shown that 26 of 38 cases (68.4%) of primary adenocarcinoma of the colon exhibited significantly elevated levels of c-myc RNA compared to normal colonic mucosa (M. D.