Atrial fibrillation after esophagectomy is a marker for postoperative morbidity and mortality.

Objective: Postoperative atrial fibrillation complicates recovery in 20% to 25% of patients after esophagectomy for cancer. The purpose of this study is to understand this phenomenon.

Methods: Between 1982 and 2000, 198 (22% of 921) patients had postoperative atrial fibrillation after esophagectomy.

Squamous cell carcinoma and adenocarcinoma of the lower third of the esophagus and gastric cardia: similarities and differences.

Squamous cell carcinoma (SCC) and adenocarcinoma (ADC) of the lower esophagus and gastric cardia were compared in their clinical features and long-term prognosis. Two hundred and ninety-five patients with SCC and 263 with ADC were reviewed. Resectability rates for SCC and ADC were 74.

Esophageal cancer in patients with a history of distal gastrectomy.

Hypothesis: There is an association between a history of distal gastrectomy and the development of esophageal cancer. Surgical treatment of esophageal cancer in patients with a history of gastrectomy is more complicated but will not result in increased mortality in an experienced center.

Design: Case-control study.

The Kirschner operation in unresectable esophageal cancer: current application.

Hypothesis: With the introduction of safe, effective nonoperative alternatives, bypass surgery for unresectable esophageal cancer is infrequently performed, but it has a limited role in palliation of esophageal cancer that needs to be defined.

Design: Retrospective cohort study.

Setting: Department of Surgery at Queen Mary Hospital in Hong Kong.

Postchemoembolization liver abscess: findings on hepatobiliary scintigraphy.

We describe a 41-year-old man with a 1-week history of nausea and vomiting 1 month after chemoembolization of a liver metastasis. The patient subsequently became febrile and developed right upper quadrant abdominal and midback pain. Findings of initial laboratory and imaging studies (a noncontrast computed tomographic [CT] scan and ultrasound) were not remarkable.

Critical appraisal of the significance of intrathoracic anastomotic leakage after esophagectomy for cancer.

Background: Leakage from esophageal anastomoses is higher than that for other gastrointestinal anastomoses. An intrathoracic anastomotic leak is a potentially catastrophic event.

Methods: Patients with and without thoracic anastomotic leakage were compared for predisposing factors.

Analysis of reduced death and complication rates after esophageal resection.

Objective: To identify factors that have contributed to reduced rates of death and complications after esophageal resection in a 17-year period at a tertiary referral center.

Summary Background Data: There has been an evolving refinement in surgical technique and perioperative management of patients undergoing esophageal resection at Queen Mary Hospital during the past two decades. As of the end of 1998, there had been no hospital deaths among the last 105 consecutive resections performed for esophageal squamous cancer.

Bronchogenic carcinoma in patients age 30 and younger.

Background: Lung cancer is rare in patients 30 years of age or younger. There is very little published data on lung cancer in this group of patients.

Methods: A retrospective review of patients 30 years of age and younger with bronchogenic carcinoma treated at Roswell Park Cancer Institute between 1973 and 1994 was done.

A 25-year thymoma treatment review.

Most thymomas are stage I or II at presentation, and they have a good prognosis with surgical treatment. Higher stage thymomas are less common and their treatment is more problematic. Our center tends to attract patients with higher stage thymomas for treatment.

Primary extremity sarcoma: what is the appropriate follow-up?

Background: Our objective was to evaluate the effectiveness of follow-up tests for detecting first local and distant recurrences in patients with primary extremity soft tissue sarcoma.

Methods: We retrospectively analyzed all adult cases of primary extremity soft tissue sarcoma (n = 174) treated between 1982 and 1992. Patients were observed every 3 months for 2 years, every 4 months the third year, every 6 months the next 2 years, and annually, thereafter.

Carcinoma of the breast during pregnancy: a review and update on treatment options.

Gestational breast cancer is occurring with increasing incidence because more women are delaying childbirth into their thirties and forties. Although breast cancer during pregnancy or within the first year postpartum is occurring more often, there is still some confusion regarding its treatment. Although breast conservation therapy has evolved as the major treatment in breast cancer, it has been thought that pregnancy was a contraindication for this type of breast cancer therapy due to risks imposed on the fetus by chemotherapy and radiation.

Effective follow-up strategies in soft tissue sarcoma.

The value of surveillance for detection of recurrences in patients with soft tissue sarcoma (STS) after definitive surgical resection of the primary tumor is based on the premise that early recognition and treatment of local or distant recurrence can prolong survival. Surveillance strategies should meet the criteria of easy implementation, accuracy, and cost-effectiveness. Although guidelines have been proposed for follow-up of patients with STS, there are few data in the medical literature on the effectiveness of these recommendations.

Bronchogenic carcinoma in young patients.

Background And Objectives: Some investigators have suggested that lung cancer in young patients has a more aggressive course and poorer prognosis than lung cancer in older patients.

Methods: A retrospective review is presented of patients less than 40 years of age with bronchogenic carcinoma treated at Roswell Park Cancer Institute between 1984 and 1994, with comparison to a cohort of patients treated in the previous decade.

Results: There were 76 patients (41 male and 35 female).

Delayed cervical esophagogastric anastomosis.

Although uncommon, ischemia of the gastric fundus can lead to catastrophic anastomotic complications after transhiatal esophagectomy. "Delaying" the anastomosis may prevent complications in occasional patients with particularly compromised gastric fundal perfusion.

Primary tumors of the mediastinum.

Background And Objectives: Diagnostic and therapeutic approaches to mediastinal tumors have changed over the past three decades. We reviewed our recent experience with these tumors and assessed the role of a multidisciplinary treatment approach.

Methods: A retrospective review of 124 patients with primary mediastinal tumors over a 25-year period.

Long-term survival after locally aggressive anorectal melanoma.

Anorectal melanoma is a rare disease and, unlike cutaneous melanoma, there are few guidelines regarding optimal management. It has a reputation for having a poor prognosis, which has been attributed to a delay in diagnosis and to a lack of effective systemic therapy. It has also been suggested that the biology of this tumor may differ from that of cutaneous melanoma.

Primary gastrointestinal non-Hodgkin's lymphoma: increasingly AIDS-related.

A retrospective study was conducted to determine the influence of the acquired immunodeficiency syndrome (AIDS) epidemic on the incidence, clinical presentation, and outcome of primary gastrointestinal lymphoma (stages I and II) over a 20-year period at a single institution. Between 1971 and 1981, there were seven cases. Fifty-eight patients were diagnosed between 1983 and 1993, and 81 per cent were AIDS-related.

N-cadherin promotes adhesion between invasive breast cancer cells and the stroma.

Calcium-dependent cell adhesion molecules (cadherins) are involved in maintaining the epithelial structure of a number of tissues including the mammary gland. In breast and other tumor types, loss of E-cadherin expression has been seen in high grade tumors and correlates with increased invasiveness. Here we show high levels of expression of N-cadherin in the most invasive breast cancer cell lines which was inversely correlated with their expression of E-cadherin.

Favorable clinical responses in subsets of patients from a randomized, multi-institutional melanoma vaccine trial.

Background: A phase III, randomized, double-blind, multi-institutional trial was performed evaluating active specific immunotherapy using vaccinia melanoma oncolysate (VMO) in the surgical adjuvant setting in patients with stage II melanoma (UICC staging). The first interim analysis showed no significant difference in disease-free and overall survival. The data were further analyzed to identify subsets of patients with improved outcome when treated with VMO.

Surgical management of melanoma.

The incidence of melanoma is rising more rapidly than any other malignancy. More conservative margins of excision have been established and the role of elective node dissection awaits determination by prospective randomized trials. Lymphoscintigraphy has clarified lymphatic drainage from watershed areas.