Prognostic factors in patients with carcinoma of the vulva--our own experience and literature review.

AIM OF THE STUDY: The objective was the analysis of prognostic factors and treatment outcomes of 104 patients with vulvar cancer, treated between 1990 and 2003 in the Center of Oncology, Maria Sklodowska-Curie Memorial Institute, Cracow, Poland. MATERIAL AND METHODS: The median age of patients was 67. Advanced disease (TNM III and IVA) was found in 54 (51.9%) patients and grade 2 and 2 in 50 (48.1%). Inguinal lymph nodes were clinically uni- or bilaterally involved in 40.4% of patients. Fifty-seven (54.8%) patients underwent radical vulvectomy with bilateral inguinal lymphadenectomy and 47 (45.2%) radical vulvectomy only. Cancer differentiation was well in 38 (36.2%) of patients, moderate in 38 (36.2%) and poor in 28 (36.6%). Adjuvant radiotherapy was applied in 30 (28.8%) cases. RESULTS: Five-year overall survival rate was observed in 44.4% of patients. Depending on TNM grade, 5-year OS rates were 61.4% for grade 1, 54.9% for grade 2, 40.1% for grade 3 and 13.3% for IVA. In patients aged < 70, 5-year OS rate was 54.7% compared to 30.5% for those > or = 70. Among patients with G1 cancer differentiation 64.4% survived five years, with G2 39.1% and with G3 24.9%, respectively. CONCLUSION: Univariate analysis revealed a statistically significant, unfavorable impact of age > or = 70, with G3 cancer differentiation, clinically confirmed inguinal lymph node involvement and TNM classification stage on 5-year overall survival. Cox multivariate analysis demonstrated that independent prognostic factors for 5-year survival were the age of the patient, clinical status of inguinal lymph nodes and TNM classification grade.

[Clinical evaluation of nitrates in exercise-induced angina]. / Ocena skutecznosci klinicznej nitratów w indukowanej wysilkiem dusznicy bolesnej.

Nitroglycerine (NTG) is still the most important angina relief drug. The aim of the study was to evaluate clinical effects and tolerance of sublingually nitroglycerine sub form Nitromint-spray in patients with exercise induced angina pectoris (AP) using treadmill electrocardiography stress test (EST). The study group consisted of 40 adults patients (mean age 57.4 +/- 10.08 years) hospitalised in our clinic with AP confirmed by clinically and electrocardiographically positive EST. Tests were performed using treadmill Marquette-Centra equipment, according to the modified Bruce protocol after 3 days wash-out period. On the fourth day two ESTs were performed: EST-0 and 30 minutes later EST-NTG after sublingual administration 0.8 mg of NTG. Among measured parameters after NTG exercise induced ST segment depression decline from 2.3 +/- 1.0 to 1.5 +/- 0.8 (p < 0.0001). EST after NTG became electrocardiographically negative in 11 patients. NTG increased workload, and time to angina pain oneset (p < 0.0001). Nitromint-spray proved to be clinically effective, well tolerated and easy to use.