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Six Recent Liposarcomas Including Largest to Date
347
OI~COLOGY Al\JD Ci-IE!YfOTHERAPY
ONCOLOGY AND CHEMOTHERAPY Six Recent Lipo§arcoma§ Including Largest to Date
H. TAKAGI, K. KATO, E. YAMADA AND T. Sucm, Department of Surgery and Clinical Pathology, Aichi Cancer Center Hospital, Nagoya, Japan
Hicl,;:man-Broviac CatJ:1ete1· Use in Cance1· Patient§
Z.
LANDOY, C. ROTSTEIN, J. LUCEY AND J. FITZPATRICK, Departments of Laboratory Medicine and Medical Oncology, Roswell Park Memorial Institute, Buffalo, and Division of Infectious Disease, State University of New York at Buffalo, Buffalo, New York
J. Surg. OncoL, 26: 260-267 (Aug.) 1984
J. Surg. Oncol., 26: 215-218 (Aug.) 1984
The authors describe 6 patients with liposarcoma. The primary sites were the retroperitoneum in 3 patients, the lower extremity in 2 and the jejunal mesentery in 1. One patient with retroperitoneal disease had the heaviest liposarcoma (40 kg.) that has been reported in the literature. One patient with thigh liposarcoma who suffered 3 recurrences and underwent hemipelvectomy has been free of disease for the last 6½ years. Histologically, all 3 patients with retroperitoneal disease had well differentiated liposarcoma, while 2 with lower extremity tumor had myxoid type liposarcoma. W. W. K. 7 figures, 1 table, 16 references
The need for prolonged and easy venous access is crucial for cancer patients receiving chemotherapy, antibiotics and various blood products. Repeated venipuncture of peripheral veins for diagnostic and therapeutic procedures causes damage to the veins. In 1973 Broviac developed a tunneled silicone rubber catheter for prolonged venous cannulation. In 1974 Hickman modified the Broviac catheter by increasing its internal lumen. Catheter-associated complications are relatively low. The authors studied 79 patients who had Hickman-Broviac catheters inserted during a 1-year period. There were 52 patients in the hematological group and 27 in the solid tumor group. Complications associated with the Hickman-Broviac catheters were infection and venous thrombosis, with infection being more common. Nine patients experienced local infection, 10 had local infection with bacteremia and 14 had severe infection. Infectious complications were more prevalent in the hematological group: 13 of the 14 severe infections were found in patients with hematological disorders. Severe infection was more common in patients with 2 catheters in place compared to those with only 1 catheter. In particular, the presence of 2 catheters significantly increased the risk of infection in hematological patients. The risk of infection may be reduced by use of only 1 catheter with either a single or double lumen. w. w. K. 1 figure, 3 tables, 14 references
Compadson of Immunologic and Enzymatic Assay of P:rostatic Acid Phosph.ata§e for Follow-Up and A!il§essment of Clinical Status of Stage D Prostate Cancew A. EL-SHrnBINY, A. BHARGAVA, 8. BECKLEY, J. FITZIPATRICK AND G. P. MURPHY, School of Medicine, Kuwait University and Departments of Labortory Medicine and Urology, Roswell Park Memorial Institute, Buffalo, New York
J. Surg. Oncol., 26: 256-259 (Aug.) 1984 The determination of serum acid phosphatase activity in patients with prostatic cancer has been used widely for clinical diagnosis and followup of this disease. The determination of enzymatic activity has not been satisfactory for early diagnosis, partly because of the multiple tissue origin and the lack of a specific substrate and inhibitor of the prostate fraction. Immunological techniques were developed to improve the specificity and sensitivity of prostatic acid phosphatase measurement. Prostatic acid phosphatase was measured in 70 patients with stage D prostatic cancer under different modalities of treatment. Prostatic acid phosphatase was determined radioimmunoassay, counter immunoelectrophoresis and enzymatic method with H~l'-'H'OHY ,_...,vo1;,u<~W to compare the usefulness of the 3 methods in followup and assessment of clinical status of stage D prostatic cancer. In the regressive state (29 patients) radioimmunoassay and enzymatic methods correlated well; both provided 17 per cent of abnormal results, with mean values of 4.7 ± 4.6 and 3 ± 1.7, respectively. In the progressive state (17 patients) the 2 methods also showed similar percentages of abnormal results, with mean values of 40 ± 38 and 19 ± 17 for radioimmunoassay and the enzymatic method, respectively. There was greater variability in the stable group owing to the difference in the tumor load. Again, the 2 methods correlated well in regard to the diagnostic sensitivity and specificity as a parameter for assessing the clinical response. Counter immunoelectrophoresis, used as a qualitative method, showed more positive than negative results and did not correlate with the clinical state. The authors believe that the conventional enzymatic method is adequate for followup and assessment of the clinical state of stage D prostatic cancer. W. W. K. 3 figures, 4 tables, 15 references
Identity of the Neoplastic Alkaline Phosphatase as Revealed With Mo:nocfo:nal Antibodies to the Placental Form of the En:-:yme J. H. LOOSE, I. DAMJANOV AND H. HARRIS, Department of Pathology and Laboratory Medicine, Hahnemann University School of Medicine and Department of Human Genetics, School of Medicine, University of Pennsylvania, Philadelphia, Amer. J. Clin.
82: 173-177
1984
The placental isoenzyme of alkaline phosphatase can be found in small amounts in the endocervix and lung. Small amounts of the enzyme resembling the placental form have been found in the testis and thymus. Curiously, larger amounts of the placental form of the enzyme have been reported from numerous malignant tumors originating in tissues not normally expressing it. The authors ascertained whether the biochemically detectable alkaline phosphatase from different tumors is immunochemically identical to the placental alkaline phosphatase molecule. A panel of 6 monoclonal antibodies to placental alkaline phosphatase and 1 polyclonal antibody was used to evaluate alkaline phosphatases identified histochemically in tumors of the breast, ovary, lung, gastrointestinal tract and kidney. Complete antigenic identity was established in only 1 lung tumor with alkaline phosphatase. Reaction with the polyclonal antibody and some monoclonal antibodies was pres-
OI~COLOGY Al\JD Ci-IE!YfOTHERAPY
ONCOLOGY AND CHEMOTHERAPY Six Recent Lipo§arcoma§ Including Largest to Date
H. TAKAGI, K. KATO, E. YAMADA AND T. Sucm, Department of Surgery and Clinical Pathology, Aichi Cancer Center Hospital, Nagoya, Japan
Hicl,;:man-Broviac CatJ:1ete1· Use in Cance1· Patient§
Z.
LANDOY, C. ROTSTEIN, J. LUCEY AND J. FITZPATRICK, Departments of Laboratory Medicine and Medical Oncology, Roswell Park Memorial Institute, Buffalo, and Division of Infectious Disease, State University of New York at Buffalo, Buffalo, New York
J. Surg. OncoL, 26: 260-267 (Aug.) 1984
J. Surg. Oncol., 26: 215-218 (Aug.) 1984
The authors describe 6 patients with liposarcoma. The primary sites were the retroperitoneum in 3 patients, the lower extremity in 2 and the jejunal mesentery in 1. One patient with retroperitoneal disease had the heaviest liposarcoma (40 kg.) that has been reported in the literature. One patient with thigh liposarcoma who suffered 3 recurrences and underwent hemipelvectomy has been free of disease for the last 6½ years. Histologically, all 3 patients with retroperitoneal disease had well differentiated liposarcoma, while 2 with lower extremity tumor had myxoid type liposarcoma. W. W. K. 7 figures, 1 table, 16 references
The need for prolonged and easy venous access is crucial for cancer patients receiving chemotherapy, antibiotics and various blood products. Repeated venipuncture of peripheral veins for diagnostic and therapeutic procedures causes damage to the veins. In 1973 Broviac developed a tunneled silicone rubber catheter for prolonged venous cannulation. In 1974 Hickman modified the Broviac catheter by increasing its internal lumen. Catheter-associated complications are relatively low. The authors studied 79 patients who had Hickman-Broviac catheters inserted during a 1-year period. There were 52 patients in the hematological group and 27 in the solid tumor group. Complications associated with the Hickman-Broviac catheters were infection and venous thrombosis, with infection being more common. Nine patients experienced local infection, 10 had local infection with bacteremia and 14 had severe infection. Infectious complications were more prevalent in the hematological group: 13 of the 14 severe infections were found in patients with hematological disorders. Severe infection was more common in patients with 2 catheters in place compared to those with only 1 catheter. In particular, the presence of 2 catheters significantly increased the risk of infection in hematological patients. The risk of infection may be reduced by use of only 1 catheter with either a single or double lumen. w. w. K. 1 figure, 3 tables, 14 references
Compadson of Immunologic and Enzymatic Assay of P:rostatic Acid Phosph.ata§e for Follow-Up and A!il§essment of Clinical Status of Stage D Prostate Cancew A. EL-SHrnBINY, A. BHARGAVA, 8. BECKLEY, J. FITZIPATRICK AND G. P. MURPHY, School of Medicine, Kuwait University and Departments of Labortory Medicine and Urology, Roswell Park Memorial Institute, Buffalo, New York
J. Surg. Oncol., 26: 256-259 (Aug.) 1984 The determination of serum acid phosphatase activity in patients with prostatic cancer has been used widely for clinical diagnosis and followup of this disease. The determination of enzymatic activity has not been satisfactory for early diagnosis, partly because of the multiple tissue origin and the lack of a specific substrate and inhibitor of the prostate fraction. Immunological techniques were developed to improve the specificity and sensitivity of prostatic acid phosphatase measurement. Prostatic acid phosphatase was measured in 70 patients with stage D prostatic cancer under different modalities of treatment. Prostatic acid phosphatase was determined radioimmunoassay, counter immunoelectrophoresis and enzymatic method with H~l'-'H'OHY ,_...,vo1;,u<~W to compare the usefulness of the 3 methods in followup and assessment of clinical status of stage D prostatic cancer. In the regressive state (29 patients) radioimmunoassay and enzymatic methods correlated well; both provided 17 per cent of abnormal results, with mean values of 4.7 ± 4.6 and 3 ± 1.7, respectively. In the progressive state (17 patients) the 2 methods also showed similar percentages of abnormal results, with mean values of 40 ± 38 and 19 ± 17 for radioimmunoassay and the enzymatic method, respectively. There was greater variability in the stable group owing to the difference in the tumor load. Again, the 2 methods correlated well in regard to the diagnostic sensitivity and specificity as a parameter for assessing the clinical response. Counter immunoelectrophoresis, used as a qualitative method, showed more positive than negative results and did not correlate with the clinical state. The authors believe that the conventional enzymatic method is adequate for followup and assessment of the clinical state of stage D prostatic cancer. W. W. K. 3 figures, 4 tables, 15 references
Identity of the Neoplastic Alkaline Phosphatase as Revealed With Mo:nocfo:nal Antibodies to the Placental Form of the En:-:yme J. H. LOOSE, I. DAMJANOV AND H. HARRIS, Department of Pathology and Laboratory Medicine, Hahnemann University School of Medicine and Department of Human Genetics, School of Medicine, University of Pennsylvania, Philadelphia, Amer. J. Clin.
82: 173-177
1984
The placental isoenzyme of alkaline phosphatase can be found in small amounts in the endocervix and lung. Small amounts of the enzyme resembling the placental form have been found in the testis and thymus. Curiously, larger amounts of the placental form of the enzyme have been reported from numerous malignant tumors originating in tissues not normally expressing it. The authors ascertained whether the biochemically detectable alkaline phosphatase from different tumors is immunochemically identical to the placental alkaline phosphatase molecule. A panel of 6 monoclonal antibodies to placental alkaline phosphatase and 1 polyclonal antibody was used to evaluate alkaline phosphatases identified histochemically in tumors of the breast, ovary, lung, gastrointestinal tract and kidney. Complete antigenic identity was established in only 1 lung tumor with alkaline phosphatase. Reaction with the polyclonal antibody and some monoclonal antibodies was pres-