RESUMEN
Elective supraomohyoid neck dissection is considered part of standard treatment of oral and oropharyngeal cancer in most institutions, but its role in the treatment of clinically positive neck cancer remains a subject of controversy. The main object of this study is to report the results of 212 consecutive patients who underwent supraomohyoid neck dissections from 1954 to 1990. Most patients had squamous cell carcinoma of the oral cavity. Eighty-six patients (40.6%) had histologically positive lymph nodes in the surgical specimen (sensitivity, 0.55; specificity, 0.53). At the study closing date there were 58.8% actuarial 10-year overall survival rates. Forty-five patients (21.2%) had 50 tumor recurrences (32 local, 13 regional, five distant), and in 40 patients (18.8%) a second primary tumor was diagnosed. A multivariate regression technique based on Cox's proportional hazards model was used, and age (65 years or younger vs older than 65 years) represented the variable with the highest predictive strength with respect to overall survival (relative risk, 2.3). Tumor site, sex, and histologically proved metastasis were also associated with overall survival rates. The same variables were also related to the risk of recurrence. In conclusion, the death rate is mainly related to the control of the primary site tumor and the occurrence of a second primary tumor rather than to neck recurrences. It confirms that supraomohyoid neck dissection is an adequate elective procedure and possibly sufficient in the treatment of a selected group of patients with lip cancer with positive nodes at level 1.
Asunto(s)
Carcinoma de Células Escamosas/cirugía , Músculos Faciales/cirugía , Neoplasias de Cabeza y Cuello/cirugía , Escisión del Ganglio Linfático , Músculos del Cuello/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/secundario , Niño , Femenino , Estudios de Seguimiento , Neoplasias de Cabeza y Cuello/patología , Humanos , Escisión del Ganglio Linfático/métodos , Ganglios Linfáticos/patología , Metástasis Linfática/patología , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/cirugía , Neoplasias Primarias Secundarias/cirugía , Pronóstico , Terapia Recuperativa , Sensibilidad y Especificidad , Tasa de SupervivenciaRESUMEN
Foram estudados 15 casos de pancreatite aguda no Serviço de Clínica Cirúrgica do Hospital Universitário de Säo Paulo. Todos os pacientes desta série foram submetidos a laparotomia exploradora, com seqüestrectomia e drenagem. Foram relacionados etiologia, sexo, idade, complicaçöes e os critérios prognósticos de Ranson, com a mortalidade. A mortalidade geral foi de 33%
Asunto(s)
Adulto , Persona de Mediana Edad , Humanos , Masculino , Femenino , Pancreatitis/cirugía , Pancreatitis/mortalidad , Complicaciones Posoperatorias , Enfermedad Aguda , Estudios Retrospectivos , Hospitales Generales , Hospitales UniversitariosRESUMEN
The authors present a study of 15 cases of necrotizing acute pancreatitis treated surgically at the Surgery Department of the University Hospital of the University of São Paulo. All patients in the series were submitted to exploratory laparotomy with sequestrectomy and drainage. Etiology, sex, age, complications, and Ranson prognostic criteria were compared to mortality. Overall mortality was 33%.