[Stewart-Treves syndrome--lymphangiosarcoma in sever lymphostasis of arm after mastectomy]. / Sindrom Stiuarta-Trivsa--limfangiosarkoma na fone vyrazhennogo limfostaza ruki posle mastéktomii.

Stewart-Treves Syndrome ('STS) is a rare, extremely malignant and quickly progressing tumor. It is angiosarcoma developing in lymphostasis of an arm after radical mastectomy for cancer. The patient aged 80 years was followed-up, in whom STS had developed 19 years after radical mastectomy. Clinical diagnosis was confirmed by pathomorphological examination of dermal biopsy. Advanced age and severe associated diseases made it impossible to carry out specific therapy. The patient died of intoxication and increasing cardio-vascular insufficiency 9 months after the onset of the disease.

[Analysis of stage IV stomach cancer diagnostic and treatment results in permanently followed-up group of population]. / Analiz rezul'tatov diagnostiki i lecheniia raka zheludka IV stadii u postoianno nabliudaemoi gruppy naseleniia.

982 case records of the patients with cancer of the stomach (CS) were analyzed for the period from 1980 to 1997. Among them tumor of stage IV made up 21.1% (autopsy data were not taken into account). The main cause of late CS diagnosis was defective system of screening for CS. The survival rate of the patients with CS stage IV did not exceed 2 years. Chemotherapy in inoperable patients allowed a reliable increase of 7% to 26% in corrected survival rate during one year. Palliative operations increase the values of 1 year survival rate of patients with CS from 5% to 60%.

[The results of treating stomach cancer at a medical center]. / Rezul'taty lecheniia raka zheludka v meditsinskom tsentre.

Results of diagnosis and treatment of gastric cancer according to the program of screening in permanently followed-up population group during 1980-1995 years, developed and introduced into practice of Medical Center of the President of Russia Administration, are analysed. According to the Cancer Register data through this period, total number of cases of this disease comprised 896 patients. Active revealing of cancer of the stomach made up 61%. The causes of advanced disease in patients with stage IV cancer have been thoroughly analysed, their share being high enough--23.5%. Due to achieved level of early diagnosis (I stage) the possibility of only radical surgical treatment rises up to 83.5%, allowing to receive a high percent of corrected 5-year (92-93%) and 10-year (83-88%) survival. Every third patient with cancer of the stomach succumbs due to causes unconnected with the progression of the disease.

[Current status of gastric cancer morbidity]. / Sovremennoe sostoianie zabolevaemosti rakom zheludka.

Gastric cancer is one of the most common diseases in patients over 70 years of age. It makes 14.4% of all malignant tumours, 15.7%--if oncohaematological cases are not included, and 19.8%--if oncohaematological cases and skin basaliomas are not considered. Most frequently the 1st stage of cancer was found in patients over 70 years of age (41.8%). The 4th stage of cancer is most commonly detected in patients of the oldest age group (34.5%). The program for early detection makes it possible to increase significantly timely diagnosis of gastric cancer (up to 80% in stages I and II). The screening program provides the detection of early stages of gastric cancer in 40.6% of the patients with the 1st stage of gastric cancer. 5-year survival is 30.2%, the corrected rate--40.3%. The rates of 5-year survival (both--observed and corrected) are the highest in patients with the 1st stage of the disease. The 5-year survival rate in patients aged 50-59 years is 65.5%; whereas in patients over 70--16.0% and 27.7% (observed and corrected, respectively).

[The current status of the diagnosis of lung cancer under the conditions of the long-term dispensary care of a population group]. / Sovremennoe sostoianie diagnostiki raka legkogo v usloviiakh dlitel'noi dispanserizatsii gruppy naseleniia.

In 1980-1995 the authors observed 739 cases of lung cancer. A special screening program on early diagnosis of lung cancer has been developed. The centralized system of the information collection, storage and processing of all the cancer cases, follow-up of all the registered cases provided observed and corrected 5- and 10-year survival. Efficacy of screening and early treatment is shown.

[Diagnosis and treatment of malignant melanoma of the skin (a lecture)]. / Diagnostika i lechenie zlokachestvennoi melanomy kozhi (lektsiia).

The authors analyse specific features of the diagnosis and treatment of malignant melanoma of the skin in individuals follaved up in 1985-1990. A program of active diagnosis of skin melanoma has been developed and introduced into practice which allowed detection of the tumor at the first stage of its development in 83% of patients and to limit the radical management to a quite economical resection (by 2-5 cm from the border of the tumor) in 72% of patients. Five-year survival was 92%.

A phase II trial of cardioprotection with Cardioxane (ICRF-187) in patients with advanced breast cancer receiving 5-fluorouracil, doxorubicin and cyclophosphamide.

From January 1991 to August 1993, 237 women with metastatic breast cancer were recruited into a multicentric phase II clinical trial designed to assess the cardioprotective activity of Cardioxane (ICRF-187). All patients were treated with 5-fluorouracil 500 mg/m2, doxorubicin 50 mg/m2, cyclophosphamide 500 mg/m2 (FDC) and Cardioxane 1000 mg/m2, in cycles repeated every 3-4 weeks. Cardiac functions were assessed at baseline by physical examination, ECG, and resting ultrasound left ventricle ejection fraction (LVEF). The same tests were repeated regularly after the 3rd, 6th, 8th cycle and every additional 100 mg/m2 of doxorubicin. At the end of the study there were 212 evaluable patients. Prior to analysis, patients were stratified according to the presence of cardiac risks at study entry. One hundred thirty-three patients (63%) bore one or more cardiac risks. The average total cumulative dose of doxorubicin administered to the group was 311 mg/m2 (range: 200-900 mg/m2). Overall response (CR + PR) was 49.5% (105/212), with 12% of patients entering complete remission. General toxicity (WHO grading) was mild and tolerable; no excessive myelosuppression or related symptoms were observed. Three patients from the risk group experienced cardiotoxicity, with an LVEF fall below 45%, and had to be removed from the study. Another 3 patients (1 from the risk group) were removed from the study due to clinically documented congestive heart failure after 200, 300 and 400 mg/m2 of doxorubicin. In our study, Cardioxane (ICRF-187) did not influence the antitumor efficacy of FDC chemotherapy, nor did concomitant administration of Cardioxane and chemotherapy result in any other or severer toxicity than that already known for this regimen. Finally, the observation that 51% of patients with preexisting cardiac risks received doxorubicin at dose range of 450-900 mg/m2 without significant clinical or laboratory signs of cardiotoxicity supports the evidence that Cardioxane provided cardiac protection offering the possibility of longer doxorubicin chemotherapy.

[Current possibilities of detection of thyroid cancer]. / Sovremennye vozmozhnosti vyiavleniia raka shchitovidnoi zhelezy.

The article deals with 83 cases of carcinoma of the thyroid gland (CTG) which were recognized in 1973-1991 among the population during annual screening. The morbidity rate was 0.18 per 1,000 population, and increased by 3.4 times. Guidelines for Active Detection of Nodular Masses and Malignant Tumors of the Thyroid were elaborated. Their essence is as follows: during regular medical screening a group of individuals is distinguished in whom palpable abnormalities are found in the thyroid and focal changes are revealed in it by ultrasonic examination whose performance is recommended once every two years; the revealed group of individuals is subjected to complex examination for establishing the diagnosis, after which the tactics of their management are determined; a oncorisk group is formed to be kept under active observation. After introduction of the Guidelines into practice, recognition of CTG in stages I-II increased from 67.8 to 80%, which testifies to their effectiveness.

[Treatment of epitheliomas]. / Lechenie épiteliom.

In a period of 6 years the authors had 615 patients with epitheliomas. Squamous cell carcinoma (SCC) was found in 22 of them, meta-typical carcinoma in 2, and basal cell carcinoma (BCC) in the remaining cases. The frequency of application and comparative efficacy of various methods of treatment were appraised. The surgical method was used most frequently--in 84.2% of patients. Cryodestruction prevailed (46.3%) among the surgical methods of epithelioma treatment. Its early results in BCC were favorable in 97% of cases. The frequency of recurrences and metastases was 0.5%. Surgical excision, applied in 31% of patients, was effective in all cases of BCC. In SCC surgical excision is performed in a complex with radiotherapy. The efficacy of combined treatment (surgery + radiotherapy) was about 100%. Generalization of the process was found in only one patient. The other methods of treatment are used much less frequently.

[Groups at high risk for skin cancer]. / Gruppy povyshennogo onkologicheskogo riska raka kozhi.

A special program aimed at detecting skin cancer at early stages was worked out and launched into use in 1989. It provides for a series of measures for primary examination and subsequent follow-up of population. Dermatologists conducted examinations of persons at high risk 2-4 times a year depending on the disease. They were joined by oncologists, whenever required, and morphological examinations were sometimes carried out. The group at high risk for skin cancer included patients older than 50, with the following pathologies: (I) Obligate precancerous dermatites: Bowen's syndrome, erythroplasia of Queyrat, Paget's disease (extramammary localization), intraepidermal epithelioma of Jadassohn, late-onset radiation dermatitis, early childhood-Kaposi's disease, Manganotti's chilitis and verrucous precancer of the lip; Optional precancerous dermatosis: childhood-onset epidermodysplasia veruciformis, actinic keratosis, cutaneous horn, keratoacanthoma, carcinoid papillomatosis of Gottron, giant condyloma of Buschke-Lowenstein, leukoplakia and limited precancerous hyperkeratosis of the lip's red edge; (2) Dermatoses involving pathological regeneration: eruthematosis, lupus tuberculosis, psoriasis (more than 15 years old), trophic ulcers, extensive scars (particularly, those caused by burns), chronic ulcerative pyoderma and pyoderma vegetans; (3) Hemorrhagic diathesis on the surface or fundus of neoplasm; (4) Consolidation at neoplasm base; (5) Absence of complaints; (6) Resistance to therapy.

[Acute pneumonia in oncology patients: problems of epidemiology]. / Ostrye pnevmonii u onkologicheskikh bolnykh: problemy épidemiologii.

Autopsy findings, analyzed retrospectively for 2564 cancer patients showed the presence of acute pneumonia in 47.43% of them (50.82% in males against 43.21% in females). When compared to noncancer controls, this difference proved significant. No correlations were noted between the incidence and extension of acute pneumonia and various sites of the tumor, between metastases, emergence and extension of the disease. Among pneumonia types focal, focal-confluent forms with involvement of the lower right lobe predominated. As for complications, pleurisy was the most common finding.

[Acute pneumonia in patients with multiple primary malignant neoplasms]. / Ostraia pnevmoniia u bol'nykh s pervichno-mnozhestvennymi zlokachestvennymi novoobrazovaniiami.

The authors review 35 cases of acute pneumonia (AP) in 30 patients with multifocal cancer. As a rule, AP was focal, ran a moderate or severe course, arose acutely with high temperature, chill, cough, purulent discharge. Auscultation registered weak vesicular breath, moist rale. Among pathological agents prevailed associations of pneumococci with gram-negative flora. AP resolved for 3-4 weeks in 2/3 of the patients, the rest of them developed lingering disease. From the point of view of antibacterial drugs efficacy, wide-spectrum drugs are preferable.

[Kidney cancer morbidity in a population group under continuous observation in dispensary care]. / Zabolevaemost' rakom pochki u postoianno nabliudaemoi gruppy naseleniia v usloviiakh dispanserizatsii.

Information on kidney carcinoma case rate among a contingent kept under continuous observation and subjected to regular medical examination is discussed. The authors had 390 cases under observation which allowed them to estimate the case rate according to the patients' sex and age group. A 5.8-fold increase of the case rate in a period of 15 years was found. In males it increased from 0.31:1000 to 1.8:1000, and was highest in the 50-59-year age group. Among females the kidney carcinoma case rate increased 2.5-fold in 15 years; it was highest among females aged over 70 (3.20:1000) and was 2.6 times higher than the case rate in the 50-59-year age group and 4.5 times higher than that in the 40-49-year age group (0.32:1000 and 1.44:1000, respectively). Kidney carcinoma takes a steady 6th place in the morbidity structure. Ultrasonic diagnosis of kidney carcinoma is the most effective method. The authors point out that study of the case rate of malignant kidney tumors is very important for elaborating the volumes of examination.