Abstract
A number of anatomic-surgical principles are important in the understanding of the natural history of malignant disease and emerge as important prognostic factors. This chapter will discuss the importance of these principles in the design and analysis of clinical trials. Anatomic aspects include the location and bulk of the tumor and the pattern of metastasis. These anatomic aspects often define which therapeutic modalities are potentially applicable and delineate the limits of therapy. Surgical participation in trials, necessary in the design and implementation of a trial, is needed in diagnosis, staging, follow-up, and therapy.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Pocock SJ, Simon R. Sequential treatment assignments with balancing for prognostic factors in controlled clinical trials. Biometrics 31: 103–115, 1975.
Livingston RB, Moore TN, Heilbrun L, et al. Small-cell carcinoma of the lung: Combined chemotherapy and radiation. Ann Int Med 88: 194–199, 1978.
Zacharski LR, Henderson WG, Rickles FR, et al. Effect of warfarin on survival in small cell carcinoma of the lung. J Am Med Assoc 245: 831–835, 1981.
Young RC, Fisher RI. The staging and treatment of epithelial ovarian cancer. Can Med Assoc J 119: 198–203, 1978.
Smith JP, Delgado G, Rutledge F. Second-look operation in ovarian carcinoma. Cancer 38: 1438–1442, 1976.
Ozols RF, Fisher RI, Anderson T, Makuch R, Young RC. Peritoneoscopy in the management of ovarian cancer. Am J Obstet Gynocol 140: 611–619, 1981.
Rosenberg SA, Flye MW, Conkle D, et al. Treatment of osteogenic sarcoma. II. Aggressive resection of pulmonary metastases. Cancer Treat Rep 63: 753–756, 1979.
Clark WH. The heterogenesis and biologic behavior of primary human malignant melanomas of the skin. Cancer Res 29: 705, 1969.
Breslow A. Thickness, cross-sectional areas, and depth of invasion in the prognosis of cutaneous melanoma. Ann Surg 172: 902–908, 1970.
Goldman LI. Decisions in the management of cutaneous malignant melanoma. Semin Oncol 7: 370–375, 1980.
Das Gupta TK. Results of treatment of 269 patients with primary cutaneous melanoma: A five year prospective study. Ann Surg 186: 201–209, 1977.
Wanebo HG, Woodruff J, Fortner JG. Malignant melanoma of the extremities. A clinicopathologic study with levels of invasion (microstage). Cancer 35: 666, 1975.
Wanebo HG, Fortner JG, Woodruff J, et al. Selection of the optimum surgical, treatment of Stage I melanoma by depth of microinvasion. Ann Surg 182: 302–315, 1975.
Balch CM, Murad TM, Soong S, et al. A multifactorial analysis of melanoma. I. Prognostic histologic features comparing Clark’s and Breslow’s staging methods. Ann Surg 188: 732–742, 1978.
Balch CM, Soong S, Murad T, et al. A multifactorial analysis of melanoma. II. Prognostic factors in patients with Stage I (localized) melanoma. Surgery 86: 343–351, 1979.
Day CL, Sober AJ, Kopf AW, et al. A prognostic model for clinical Stage I melanoma of the upper extremity. Ann Surg 193: 436–440, 1981.
Dukes CE. The classification of cancer of the rectum. J Pathol Bacteriol 35: 323–332, 1932.
Astler VA, Coller FA. The prognostic significance of direct extension of carcinoma of the colon and rectum. Ann Surg 139: 846–855, 1954.
Donegan WL, Decosse JJ. Pitfalls and controversies in the staging of colorectal carcinoma. In Carcinoma of the Colon and Rectum, Enker WE (ed.). Chicago: Yearbook Medical Publishers, 1978.
Gastrointestinal Tumor Study Group. Adjuvant therapy of colon cancer—results of a prospectively randomized trial. N Engl J Med 310: 737–743, 1984.
Gastrointestinal Tumor Study Group. Prolongation of the disease-free interval in surgically-treated rectal carcinoma. N Engl J Med 312: 1465–1473, 1985.
Griffiths CT, Parker LM, Fuller AF. Role of cytoreductive surgical treatment in the management of advanced ovarian cancer. Cancer Treat Rep 63: 235–240, 1979.
Hanson MB, Powell DE, Donaldson ES, van Nagell JR. Treatment of epithelial ovarian carcinoma by surgical debulking followed by single alkylating agent chemotherapy. Gynecol Oncol 10: 337–342, 1980.
Dembo AJ, Bush RS, Beale FA, et al. The Princess Margaret Hospital study of ovarian cancer: Stage I, II, and asymptomatic III presentations. Cancer Treat Rep 63: 249–254, 1979.
Edmonson JH, Fleming TR, Decker DG, et al. Different chemotherapeutic sensitivities and host factors affecting prognosis in advanced ovarian carcinoma versus minimal residual disease. Cancer Treat Rep 63: 241–247, 1979.
Piccart MJ, Speyer JL, Wernz JC, Noumoff J, Bellcr U, Beckman M, Dubin N, Demopoulos R, Muggia F. Advanced ovarian cancer: 3 year results of an intensive (6–8 month) 2 drug cisplatin containing regimen. Submitted to J Clin Oncol.
Decker DG, Fleming TR, Malkasian GD, et al. Cyclophosphamide plus cis-platinum in combination. Treatment program for Stage III or IV ovarian carcinoma. Obstet Gynecol 60: 481–487, 1982.
Merrin C, Takita H, Weber R, et al. Combination radical surgery and multiple sequential chemotherapy for the treatment of advanced carcinoma of the testis (Stage III). Cancer 37: 20–29, 1976.
Merrin C, Takita H, Beckley S, Kassis J. Treatment of recurrent and widespread testicular tumor by radical reductive surgery and multiple sequential chemotherapy. J Urol 117: 291–295, 1977.
Merrin CE, Takita H. Cancer reductive surgery: Report on the simultaneous excision of abdominal and thoracic metastases from widespread testicular tumors. Cancer 42: 495–501, 1978.
Javadpour N, Ozols RF, Anderson T, et al. A randomized trial of cytoreductive surgery followed by chemotherapy versus chemotherapy alone in bulky stage III testicular cancer with poor prognosis. Cancer 50: 2004–2010, 1982.
Merrin C, Beckley S, Takita H. Multimodal treatment of advanced testicular tumor with radical reductive surgery and multisequential chemotherapy with cis-platinum, bleomycin, vinblastine, vincristine, and actinomycin D. J Urol 120: 73–76, 1978.
Fisher B. Laboratory and clinical research in breast cancer—A personal adventure: The David A Karnofsky Memorial Lecture. Cancer Res 40: 3863–3874, 1980.
Fisher B. Cancer surgery: A commentary. Cancer Treat Rep 68: 31–41, 1984.
Matthews MJ, Hirsch FR. Problems in the diagnosis of small cell carcinoma of the lung. In Small Cell Lung Carcinoma, Greco SA, Oldham R, Bunn PA, (eds.). New York: 1981 Grune & Stratton, pp. 35–50.
Cahan WG, Castro EB, Hajdu SI. The significance of a solitary lung shadow in patients with colon carcinoma. Cancer 33: 414–421, 1974.
Minton JP, Foecking MK, Webster DJJ, Mathews RH. Response of fibrocystic disease to caffeine withdrawal and correlation of cyclic nucleotides with breast disease. Am J Obstet Gynecol 135: 157–158, 1979.
Piver MS, Shashikant L, Barlow JJ. Preoperative and intraoperative evaluation in ovarian malignancy. Obstet Gynecol 48: 312–315, 1976.
Cannon WB, Nelson TS. Staging of Hodgkin’s disease: A surgical perspective. Am J Surg 132: 224–229, 1976.
Kaplan HS, Dorfman RF, Nelsen TS, et al. Staging laparotomy and splenectomy in Hodgkin’s disease: Analysis and patterns of involvement in 285 consecutive unselected patients. Natl Cancer Inst Monogr 36: 291–302, 1973.
Kaplan HS. Hodgkin’s Disease, 2nd ed. Cambridge, Mass.: Harvard University Press, 1980, p. 575.
Rosenberg SA. A critique of the value of laparotomy and splenectomy in the evaluation of Hodgkin’s disease. Cancer Res 31: 1737–1740, 1971.
Chabner BA, Johnson RE, Young RC, et al. Sequential nonsurgical and surgical staging of non-Hodgkins lymphoma. Ann Int Med 85: 149–154, 1976.
Terry WD, Rosenberg SA, eds. Immunotherapy of Human Cancer. New York: Elsevier North-Holland, 1982.
Rubin P, Keys H. The staging and classification of cancers: A unified approach. In Principles of Cancer Treatment, Carter SK, Glatstein E, Livingston RB (eds.). New York: McGraw Hill, 1981, p. 21.
Veronesi U, Adamus J, Bandiera DC, et al. Inefficacy of immediate node dissection in stage I melanoma of the limbs. N Engl J Med 297: 627–630, 1977.
Sutcliffe SB, Katz D, Stansfeld AG, et al. Posttreatment laparotomy in the management of Hodgkin’s disease. Lancet 2: 57–60, 1978.
Martin EW Jr, Cooperman M, Carey LC, Minton JP. Sixty second-look procedures indicated primarily by rise in serial carcinoembryonic antigen. J Surg Res 28: 389–394, 1980.
Einhorn LH, Williams SD. Chemotherapy of disseminated testicular cancer. Cancer 46: 1339–1344, 1980.
Williams S, Einhorn L, Greco A, et al. Disseminated germ cell tumors: A comparison of cisplatin plus bleomycin plus either vinblastine (PVB) or VP-16 (BEP). Proc ASCO 4: 100, 1985.
Reimer RR, Hoover R, Fraumeni JF, et al. Acute leukemia after alkylating agent therapy of ovarian cancer. N Engl J Med 297(4): 177–81, 1977.
Von Hoff DD, Rozencweig M, Layard M, et al. Daunomycin induced cardiomyopathy: A review of 110 cases. Am J Med 62: 200–208, 1977.
Loudon RG. Thoracic tuberculosis: Clinical aspects. Semin Roentgenol 14: 179–191, 1979.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1987 Martinus Nijhoff Publishing, Boston
About this chapter
Cite this chapter
Kubota, T.T., Dewys, W.D. (1987). Anatomic and Surgical Principles in Cancer Clinical Trials. In: Muggia, F.M., Rozencweig, M. (eds) Clinical Evaluation of Antitumor Therapy. Developments in Oncology, vol 46. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2317-4_6
Download citation
DOI: https://doi.org/10.1007/978-1-4613-2317-4_6
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4612-9425-2
Online ISBN: 978-1-4613-2317-4
eBook Packages: Springer Book Archive