Radiotherapeutic results in malignant germinal testicular neoplasms

The results of highvoltage therapy in patients with malignant germinal tumors of the testicle are reported. The radiation technique applied is mentioned, and problems concerning the formation of metastases as well as the prognosis for seminomas and teratomas are considered.     

Risk of malignant neoplasms in patients with pulmonary sarcoidosis

BACKGROUND: For over 20 years the association between sarcoidosis and malignancy, particularly lymphoma and lung cancer, has been disputed with misclassification being the major concern. The aim of the present study was to analyse the incidence of malignancies in a cohort of patients with sarcoidosis by linkage to a nationwide population based cancer register. METHODS: The cohort comprised 254 patients followed for a median of 25 years until death, emigration, or 31 December 1992, whichever came first. The expected number of cancer cases was calculated using the annual age and sex specific cancer rates from the Danish Cancer Registry. RESULTS: Thirty six cancers were registered, three of which were misclassified as sarcoidosis, leaving 33 cancers compared with 23 expected (standardised incidence ratio (SIR) = 1.4; 95% CI 0.99 to 2.0). Five lung cancers were observed compared with 2.5 expected, yielding an SIR of 2.0 (95% CI 0.7 to 4.7). There was no incidence of lymphoma and only one case of leukaemia. There was a significant excess number of pharyngeal cancers based on two cases (SIR = 15.4; 95% CI 1.7 to 56). CONCLUSIONS: This study does not support the theory of an association between sarcoidosis and malignancy, and the main reason other studies have shown such an association is most likely to have been due to selection bias and misclassification.     

Lung neoplasms in patients under 40 years of age. Treatment results in patients qualifying for surgical treatment

In last decades an increase of new cases of lung cancer has been observed. The global prognosis based on the analysis of the increase rate of new cases envisages that total number of lung cancer patients will reach 2 millions at the end of the XXth century. In Poland alone, the number of new cases can come up to 50,000 a year in the second decade of the XXIst century. Respectively, the number of surgically treated patients with lung cancer increases. In literature, controversial opinions on the results of surgical therapy of patients with lung cancer younger than 40 years can be found. Some authors report unsatisfactory results. The others do not confirm differences due to the age of operated patients. We present our observations based on the clinical analysis of 46 patients below 40 years of age treated surgically because of lung cancer. The aim of this analysis is the evaluation of the long-term results of surgical therapy in this group of patients. This is the first Polish report on this problem.     

Serum 5-nucleotidase and alkaline phosphatase in patients with malignant neoplasms]

The biosynthetic abilities of WI-38 fibroblasts from early and late population-doubling-level cultures were compared by autoradiography of cells grown with labeled precursors of DNA, RNA, protein and lipids. Incorporation of radioactive thymidine, uridine, protein-hydrolysate, acetate, oleic acid and cholesterol, as measured by the number of grains per cell surface, decreased with the progressive aging of the culture. However, the decrease in the incorporation of acetate, oleic acid and cholesterol was much smaller than that of the other precursors, indicating that lipid synthesis is affected to a lesser degree than protein and nucleic acid synthesis on aging. This result is in accord with the higher lipid content and proliferation of intracellular membranes in cells of "old" WI-38 cultures reported by others.     

Treatment of patients with malignant neoplasms of the nose and paranasal sinuses

The author analyzes and discusses characteristic features of the results of combined treatment in 260 patients with malignant tumours of the superior maxilla, nose and accessory sinuses. The majority of patients were from 40 to 60 years old (81.5%). These were 158 men and 102 women. Epithelial tumours were diagnosed in 91.5%, sarcomas in 8.5% cases. The flattened-cell form of cancer with or without keratosis was diagnosed in 82.7%; other forms of cancer-in 17.3% cases. Sarcoma in women was diagnosed 3.5 times as often as in men. Tumours of the I stage were found in 12, of the II stage in 34. of the III stage in 146, of the IV stage in 73 patients. All patients were subjected to combined treatment-telegammatherapy and resection of the tumour with an electroknife. Patients with cancer of the I stage were first operated on with the electroknife and then subjected to radiotherapy with a focal dose of 3000-4000 rad. The 34 patients with cancer of the II stage underwent preoperative radiotherapy with a focal dose of 4500 to 5000 rad, then surgical intervention followed in 2-5 weeks. Preoperative radiotherapy was practiced in the 146 patients with cancer of the III stage, the total dose per focus being 5000-6000 rad, surgical intervention followed in 3-5 weeks. The 73 patients with cancer of the IV stage were operated on after radiotherapy with a focal dose of 6500-700 rad. Early and remote results of combined treatment in 260 patients were favourable. The length of life was up to 3 years in 119 (45.77%), up to 5 years in 74 (28.46%), up to 10 years in 48 (18.5%), over 10 years in 22 (8.5%) patients.     

Statistics of malignant neoplasms in children in Russia

Deletion and insertion mutations have been found to be a major component of the in vivo somatic mutation spectrum in the hypoxanthine phosphoribosyltransferase (hprt) gene of T-lymphocytes. In a population of 172 healthy people (average age, 34; mutant frequency, 10.3 x 10(-6)), deletion/insertion mutations constituted 41% (89) of the 217 independent mutations, the remainder being base substitutions. Mutations were identified by multiplex PCR assay of genomic DNA for exon regions, by sequencing cDNA, or sequencing genomic DNA. The deletion and insertion mutations were divided among +/- 1 to 2 basepair (bp) frameshifts (14%, 30), small deletions and insertions of 3-200 bps (13%, 28), large deletions of one or more exons (12%, 27), and complex events (2%, 4). Frameshift mutations were dominated by -1 bp deletions (21 of 30). Exon 3 contained five frameshift mutations in the run of 6 Gs, the only site in the coding region with multiple frameshift mutations, possibly caused by strand dislocation during replication. Both endpoints were sequenced for 23 of the 28 small deletions/insertions including two tandem duplication events in exon 6. More small deletions (8/28), possibly mediated by trinucleotide repeats, occurred in exon 2 than in the other exons. Large deletions included total gene deletions (6), exon 2 + 3 deletions (4), and loss of multiple (9) and single exons (8) in genomic DNA. The diverse mutation spectrum indicates that multiple mechanisms operated at many different sequences and provides a resource for examination of deletion mutation.     

Therapeutic node dissections in malignant melanoma

BACKGROUND: Therapeutic lymphadenectomies involve the dissection and removal of clinically enlarged, histologically positive nodes at the regional nodal basin, in the absence of detectable distant disease. METHODS: The literature dealing with therapeutic lymphadenectomies in malignant melanoma was reviewed. RESULTS: The rate of wound complications varies with the particular nodal basin. The 5-year survival varies from 19% to 38%, with an average of 26%. Survival is affected primarily by the number of histologically positive nodes and extracapsular spread, and secondarily by the extent of disease at the various levels of the nodal basin, fixation of the nodes, and, probably, the preceding disease-free interval. Prognostic parameters of the primary lesion, e.g., thickness, ulceration, and location, also may have an effect on survival. The rate of local recurrence at the nodal basin after lymphadenectomy has varied from 0.8% to 52%. Adjuvant therapy with interferon alfa-2b has improved the 5-year disease-free survival from 26% to 37%. CONCLUSIONS: Therapeutic node dissections in melanoma provide an appreciable 5-year survival rate, which is further augmented by adjuvant therapy. Many series report a significant rate of local recurrence at the nodal basin following therapeutic dissection. Complete lymphadenectomy reduces the rate of local failure with its attendant morbidity.     

Results of radiotherapy of malignant testicular neoplasms

It is very difficult to compare the therapeutic results of malignant testicular tumours because of the different histological classification systems, the uncertainty in the definition of the different stages, the error rate of the lymphography which amounts up to 35%, and the multitude of surgical, radiation, and chemotherapeutic methods. A histological classification and an exact determination of the stage is required as a condition of beginning a radiotherapy. The desirable focal dose for seminomas is between 4000 and 5000 rad, the maximum dose for teratomas is 6000 rad. For the stages T1-3N0 the iliac and the paraaortic lymph nodes are irradiated, for the stages T1-4N1-2 the interpleural space andthe supraclavicular region are included. For a group of 91 patients there was reached a five-year survival rate of 85,5% in case of seminomas and of 64% in case of teratomas.     

Thyroid neoplasms in some regions of Russia after radiation accident in Chernobyl

There is an increase of thyroid carcinoma incidence in regions contaminated after the Chernobyl accident as well as in Russia on the whole. The most considerable increase occurred in younger age groups of population. No difference in thyroid tumors structure was found in polluted with radionuclides and non-polluted regions.     

Thyroid nodules: malignant or benign?

Palpation of a thyroid nodule should initiate a workup to exclude the rare but dangerous possibility of malignancy or autonomous function. Clinical evaluation will at times provide clues to malignancy, but the diagnostic cornerstone is fine-needle aspiration biopsy. Treatment may include observation, surgery, levothyroxine, or radioactive iodine.