Surgery – Miscellaneous – Methods
Reexamination Certificate
1999-09-14
2002-01-29
Isabella, David J. (Department: 3738)
Surgery
Miscellaneous
Methods
Reexamination Certificate
active
06341608
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates to a new method for resection of tumors by surgery.
BACKGROUND AND SUMMARY OF THE INVENTION
Malignant tumors located in the mucosa are very common throughout the population, and a vast majority of these tumors consist of so-called squamous cell carcinomas. The development of tumors in the mucosa is often promoted and/or caused by intake of carcinogenic substances, such as tobacco and alcohol. Furthermore, this type of tumors is often very aggressive and thus associated with a high mortality rate. Indeed, despite major advances in surgery, chemotherapy and radiation therapy, about 50% of the afflicted patients die from their cancer disease within a 5-year period after tumor diagnosis.
A vast majority of the tumors located in the mucosa are treated by surgery. However, such surgery is often technically complicated, and this is mainly a result of the general difficulty of access to these tumors. This is particularly the case if they are located in the throat or the oral cavity. Furthermore, a specific characteristic associated with tumors in the mucosa is a high abundance of newly developed tumors located on adjacent surfaces, including the surfaces of the respiratory tract. Indeed, such new tumors (known as “second primaries”) are observed in about 10-20% of the patients within a 10-year period following a successful resection of the primary tumor.
Recent molecular biology research (see Worsham, M. J. et al.,
Human Pathology
, 26(3), 251-261, 1995 and Bedi, G. C. et al.,
Cancer Res
., 56, 2484-2487, 1996) suggests that said second primaries are related to the primary tumor, and that they are in fact of the same monoclonal origin.
It is also known that the unavoidable mechanical handling of tumors during resection thereof often results in a tumor spillage, and detectable amounts of tumor cells have been observed on instruments and gloves used in surgery (see e.g. Curran, A. J., Smyth, D., Timon, C. V. I., “Reducing the risk of implantation of malignant cells intra-operatively”, Abstract 401, 4
th
International Conference on Head and Neck Cancer, July 28-August 1, Toronto, CA, 1996). For inter alia this reason, it has for a long time been common practise during surgery to change both gloves and instruments before reconstructive surgery begins after the tumor has been resected.
In short, a likely explanation for the occurrence of said second primaries is that they are so-called implantation metastases resulting from tumor cells deposited and subsequently implanted on healthy tissue surfaces, whereby a new tumor is developed.
In summary, the occurrence of new tumors associated with resection of tumors, particularly of those located in the mucosa, is a problem which yet remains to be solved.
REFERENCES:
patent: 5573934 (1996-11-01), Hubbell et al.
patent: 5843156 (1998-12-01), Slepian et al.
patent: 6110484 (2000-08-01), Sierra
Baker & McKenzie
Isabella David J.
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