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ABSTRACT: Analysis of 3445 cases of cancer of the larynx has been made with reference to primary (first) and secondary treatments. It is easy to confirm that while radiotherapy is inferior to laryngectomy in the cure of larger glottic tumours, it is preferable in many cases because salvage surgery is possible and successful. Salvage surgery cannot be shown to be successful in larger supraglottic tumours, which should be considered for primary surgery. Radiotherapy appears better than surgery for small tumours.
Clinical Otolaryngology 05/1991; 16(2):193-7. · 2.39 Impact Factor
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Clinical Otolaryngology 05/1991; 16(2):198-201. · 2.39 Impact Factor
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ABSTRACT: Between 1957 and 1981, 31,716 cases of gastric cancer were registered in the West Midlands, UK. The age-standardized incidence has shown a decrease from 17.42 per 100,000 population during the first quinquennium to 15.30 per 100,000 in the last. There was an apparent increase in the proportion of proximal lesions with a decrease in the proportion of distal, antral cancers. The stage of disease at diagnosis remained constant with 79 per cent of patients having stage IV disease. Less than 1 per cent presented with stage I disease. As a result, the curative resection rate was 21 per cent. The operative mortality rates for curative partial gastrectomy and total gastrectomy were 13 and 29 per cent respectively. Surgeons undertaking more than nine total gastrectomies annually had an overall mean operative mortality rate of 22 per cent. Overall age-adjusted survival at 5 years was 5 per cent. Survival at 5 years for stage I, II and III disease was 72, 32 and 10 per cent respectively. There was a significant increase in survival time for those treated by curative resection between 1972 and 1981 compared with the previous decade. The implications for the management of gastric cancer are discussed.
British Journal of Surgery 07/1989; 76(6):535-40. · 4.61 Impact Factor
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ABSTRACT: From 1957 to 1976 oesophageal resection for carcinoma was performed in 1119 patients reported to the West Midlands Cancer Registry. The operations were performed on 581 patients by 127 surgeons who averaged three or less resections per annum (the 'occasional' group). These were compared with 538 patients (the 'frequent' group) whose resections were performed by four surgeons who averaged six or more resections per annum. Operative mortality was 39.4 per cent in the 'occasional' group and 21.6 per cent in the 'frequent' group (P less than 0.001). The age adjusted 5-year survival was 11.1 and 15.2 per cent respectively (P less than 0.05) but when the operative deaths were excluded there was no significant difference. We suggest that oesophageal resection for carcinoma should be performed only where there is an acceptably low operative mortality rate.
British Journal of Surgery 09/1986; 73(8):621-3. · 4.61 Impact Factor
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ABSTRACT: The results of the radical treatment of 528 cases of carcinoma of the nasal cavity and paranasal sinuses are presented. These cases were analysed according to treatment modes of surgery of radiotherapy alone and surgery, radical or subradical, with radical radiotherapy. Of necessity the survey is retrospective but the results can be interpreted as demonstrating that while surgery without radiotherapy is appropriate to certain tumours near the nasal vestibule, to transitional cell carcinoma in men, and to some salivary carcinomas, for the remainder surgery, either radical or subradical with radiotherapy, is appropriate. No significant difference can be shown between radical and subradical surgery, when combined with radiotherapy. Radiotherapy alone appears inappropriate.
Clinical Otolaryngology 01/1982; 6(6):401-14. · 2.39 Impact Factor
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Zeitschrift für Gastroenterologie 06/1981; 19(5):244. · 0.90 Impact Factor
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ABSTRACT: Two hundred eighty-two cases of 624 cases of carcinoma of the nasal cavity and paranasal sinuses were studied. All had a clinical evaluation of the extent of carcinoma, followed by surgical procedures. By a process of defining 13 possible compartments or extensions and enumerating them before and after surgery, it was possible to show that approximately one third of the cases had errors in preoperative assessment. Underestimates preponderated. It is suggested that diagnosis is one important role of surgery, in addition to the directly therapeutic effect of excision. Surgery is also essential as a guide to further excision and to the accurate application of radiotherapy treatment fields.
Archives of otolaryngology (Chicago, Ill.: 1960) 04/1981; 107(3):138-40.
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ABSTRACT: In "early" gastric cancer the depth of invasion by the primary tumour is confined to the submucosa of the stomach. Out of 13228 cases of gastric cancer notified to the Birmingham Cancer Registry during 1960-9, 90 (0 . 7%) were identifed as early gastric cancer. The crude five-year survival rate of these 90 patients was 57 . 8% (age-adjusted rate 70 . 4%) compared with 3 . 7% (age-adjusted rate 4 . 7%) for all cases and 14 . 6% (age-adjusted rate 17 . 4%) for the cases treated radically. Prognostic factors established for gastric cancer pertained equally to early gastric cancer. Most of the 90 patients had had symptoms related to the gastrointestinal tract, but in contrast to patients with advanced gastric cancer only 19% had lost weight on admission. These findings suggest that early investigation of dyspeptic symptoms would increase the detection of early gastric cancer, the most important prognostic group identified in gastric cancer.
British medical journal 11/1980; 281(6246):965-7.
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Clinical Otolaryngology 05/1980; 5(2):139-56. · 2.39 Impact Factor
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ABSTRACT: Of 624 cases of carcinoma of the nasal cavity and paranasal sinuses the presence or absence of metastasis to the regional nodes or to distant sites was recorded. Regional nodes were involved in 14.3 per cent, varying according to site and histological type. Disseminated metastases were found in 1.6 per cent. The prognosis for those with involved nodes was severely reduced, and for those with distant metastases it was negligible. This bleak outlook should be considered when treatment is being planned.
The Journal of Laryngology & Otology 04/1980; 94(3):301-9. · 0.60 Impact Factor
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Clinical Otolaryngology 01/1980; 4(6):431-56. · 2.39 Impact Factor
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ABSTRACT: One hundred and eight patients with advanced carcinoma of the breast were treated by trans-sphenoidal hypophysectomy and followed up for at least 1 year. The results were assessed both by clinical response and objectively by survival following hypophysectomy, as expressed by the survival ratio. The two methods showed close correlation. The results show that there is a variation in response relating to menopausal status and age at diagnosis, subsequent hormonal manipulaton and physical condition at hypophysectomy. Younger patients whose carcinoma is diagnosed after menopause carry a good prognosis, yet the older premenopausal patients, especially if their clinical condition is poor, do not benefit. Easily available clinical information can be a guide to prognosis.
British Journal of Surgery 03/1975; 62(2):85-91. · 4.61 Impact Factor
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British Journal of Surgery 07/1968; 55(6):405-10. · 4.61 Impact Factor
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British medical journal 07/1965; 1(5450):1577-83.
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Proceedings of the Royal Society of Medicine 12/1962; 55:985-8.
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Archives of Disease in Childhood 09/1962; 37:371-7. · 2.88 Impact Factor
