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- Sriplakich, S., et al.
(författare)
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Epidermal growth factor receptor expression : predictive value for the outcome after cystectomy for bladder cancer?
- 1999
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Ingår i: BJU International. - Oxon, United Kingdom : Blackwell Publishing. - 1464-4096 .- 1464-410X. ; 83:4, s. 498-503
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine whether epidermal growth factor receptor (EGFR) immunostaining of tumour cells is associated with cancer-specific death after cystectomy for locally advanced bladder cancer.Patients and Methods: The hospital records of all patients treated with cystectomy for urothelial cancer of the urinary bladder between 1967 and 1992 were reviewed retrospectively. The paraffin-embedded specimens obtained before treatment from 173 patients were processed for immunohistochemical staining, using the monoclonal antibody NCL-EGFR (Novocastra, UK). EGFR immunostaining was considered positive if membrane staining was found in at > or = 20% of tumour cells in one or more fields at > or = 200 (area 0.59 mm2).Results: Most patients (149) received preoperative irradiation and one had neoadjuvant chemotherapy. The mean observation time was 81.3 months; 63 patients (36%) had tumour recurrence within 1-80 months (mean 18.3). Positive EGFR immunostaining was found in 100 patients (58%). The proportion of T2-4 tumours was higher in those EGFR-positive than in those EGFR-negative. Proportional-hazards analysis revealed that clinical stage was significantly associated with cancer-specific death, but EGFR expression was not.Conclusion: Although positive immunostaining for EGFR was more frequent in higher stages of locally advanced bladder cancer, this variable was not an independent predictor of outcome after cystectomy.
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- Jahnson, S, et al.
(författare)
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Anastomotic blood-flow reduction in rat small intestine with chronic radiation damage.
- 1998
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Ingår i: Digestion. - 0012-2823 .- 1421-9867. ; 59:2, s. 134-41
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/AIMS: Anastomoses in previously irradiated intestine are prone to leakage, possibly due to an impeded blood supply. Whether or not chronic radiation damage actually predisposes to a disturbed blood flow in the vicinity of anastomoses was investigated in the rat small bowel.METHOD: A 2-cm segment of rat ileum was irradiated with a single dose (21 Gy). After 20 weeks an anastomosis was created in the irradiated segment and in the corresponding segment of controls. Another 4 days later local blood flow was studied with the 14C-iodoantipyrine autoradiography technique in 16 sectors around the circumference both in the anastomotic segment and in a segment 4 mm apart.RESULTS: In the anastomotic segment, the average blood flow was reduced in irradiated compared with non-irradiated animals in the mucosal layer (p = 0.034), but not in the muscular layer (p = 0.08). In the mesenteric quadrant blood flow was reduced in irradiated compared with non-irradiated animals, both in the mucosal layer (p = 0.012) and in the muscular layer (p = 0.05). More irradiated than non-irradiated animals showed a blood-flow reduction to 15% or more in 13-16 sectors both in the mucosal (p = 0.015) and the muscular layer (p = 0.04).CONCLUSIONS: The results favor the hypothesis that anastomoses in previously irradiated intestine are vascularly compromized and thereby have an increased risk of leakage.
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- Jahnson, S, et al.
(författare)
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Anastomotic breaking strength and healing of anastomoses in rat intestine with and without chronic radiation damage.
- 1995
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Ingår i: European Journal of Surgery. - 1102-4151 .- 1741-9271. ; 161:6, s. 425-30
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess the influence of chronic radiation damage on anastomotic healing in the small bowel in rats.DESIGN: Controlled laboratory study.SETTING: University hospital, Sweden.MATERIAL: 90 male Sprague-Dawley rats.INTERVENTIONS: A short segment of the distal ileum was exteriorised and irradiated with a single dose (experimental group, n = 45) or exposed only (control group, n = 45). Twenty weeks later resection and anastomosis were done within this segment using 7/0 polypropylene.MAIN OUTCOME MEASURES: The anastomotic breaking strength, the amount of perianastomotic hydroxyproline, and the number of anastomotic complications.RESULTS: The breaking strength and the amount of perianastomotic hydroxyproline were higher in the irradiated than in the non-irradiated group. In contrast, anastomotic complications were significantly more common in irradiated animals.CONCLUSION: Anastomotic complications in irradiated intestine are not related to the amount of perianastomotic collagen or to breaking strength.
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- Jahnson, S, et al.
(författare)
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Extent of blood transfusion and cancer-related mortality after cystectomy and urinary diversion for bladder cancer
- 1994
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Ingår i: British Journal of Urology. - : BLACKWELL SCIENCE LTD. - 0007-1331 .- 1365-2176. ; 74:6, s. 779-784
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:To assess the possible adverse effect of peri-operative blood transfusion on cancer-related survival after radical cystectomy for bladder cancer.PATIENTS AND METHODS:The hospital records of 130 patients treated with cystectomy and urinary diversion for bladder cancer between 1967 and 1986 were retrospectively reviewed.RESULTS:Standard proportional hazards estimation revealed tumour stage and radiation response after pre-operative irradiation to be significantly associated with cancer-related mortality, whereas age, tumour grade or the extent of peri-operative blood transfusion were not. In models which allowed time varying effects a significantly changed effect of blood transfusion (> or = 7 versus < or = 6 units) was observed, from an initially insignificantly increased relative hazard (RH) (RH = 1.44 at 6 months) to an insignificantly decreased effect after longer follow-up (RH = 0.53 after 2 years).CONCLUSION:Although no overall association between blood transfusion and cancer-related mortality was found, a tendency towards an increased risk early in the follow-up period was observed if more than 6 units were transfused. However, these results need confirmation in further studies before a restrictive attitude towards peri-operative blood transfusion is recommended.
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