[Immunophenotype of lymphocytes of patients with malignant melanoma and its dynamics during immunotherapy with interleukin-2]. / Immunologicheskii fenotip limfotsitov bol'nykh so zlokachestvennoi melanomoi i ego dinamika v protsesse immunoterapii interleikinom-2.

A Mab set was used to study immunological phenotype of lymphocytes of five patients bearing stage IV malignant melanoma and its changes developing in the course of interleukin-2 (Euro cetus) immunotherapy. Patients were shown to have lowered counts of T cells (mainly due to T-helper/inducers), B cells and lymphocytes expressing adhesion and activation molecules as well as abnormal immunoregulatory cell ratio. Two patients receiving interleukin-2 achieved a response. Follow-up of antigen expression revealed a rise in natural killer and immunoregulatory T lymphocyte levels in the responders whereas activation antigens and B cell levels were increased in all the patients.

[Multifactorial analysis in the prognostication of the incidence of recurrences, metastases and survival of patients with squamous cell cancer of the skin]. / Mnogofaktornyi analiz v prognozirovanii chastoty poiavleniia retsidivov, metastazov i vyzhivaemosti bol'nykh ploskokletochnym rakom kozhi.

A retrospective analysis of the data on 116 cases of squamous cell carcinoma of the skin of the body and extremities was undertaken. Eight parameters were found to influence metastasis formation and five-year survival: extent of involvement according to TNM classification, background conditions of tumor development, duration of disease, rate of tumor growth, gross appearance of tumor, site, contour and histologic pattern of malignancy. Recurrence development was influenced by nine parameters including those mentioned above plus extent of surgery. Tables for calculating likelihood of metastasis and recurrence development and five-year survival are provided. Credibility assured by these tables is as high as 75.0% in prognosing relapse, 96.4% in prognosing metastases and 93.6% in determining five-year survival.

[Combined treatment of patients with metastases of skin melanoma using cryotherapy]. / Kompleksnoe lechenie bol'nykh s metastazami melanomy kozhi s ispol'zovaniem krioterapii.

Cryotherapy or cryotherapy plus intratumoral injection of BCG vaccine were used in combination with either prospidin or imidazole-carboxamide and multidrug chemotherapy including vincristine, dactinomycin and CCNU for the treatment of 106 cases of cutaneous and subcutaneous metastases of skin malignant melanoma. Five-year survival for the entire group was 36 +/- 5.1%. The best results were obtained for prospidin (43.6 +/- 8.6%) (imidazole-carboxamide--31.3 +/- 9.4% and combined chemotherapy--30.5 +/- 5.8%). Imidazole-carboxamide should be used in conjunction with cryotherapy plus intratumoral BCG vaccine. Procedure of topical treatment did not significantly influence the effectiveness of prospidin or combination chemotherapy.

[Metastases of skin melanoma from unknown primary site]. / Metastazy melanomy kozhi bez pervichno vyiavlennogo ochaga.

Out of 3,822 cases of malignant skin melanoma from an unknown primary site, metastases were registered in 53 (1.4%). The male/female ratio was 3:1. The rates of 3-, 5- and 10-year survival were evaluated versus sex, time to treatment, metastatic site and therapeutic modality. The shortest survival was associated with metastasis into cervical lymph nodes, while the longest one (with an overall 3-year survival rate of 40%)--with involvement of a single lymphatic zone. The latter group should be given a complex treatment including a standard regional lymphadenectomy with adjuvant chemo- and immunotherapy. Such treatment resulted in a 3-year survival in 50% of cases. The overall survival rates in patients with metastasis of malignant skin melanoma with an unknown primary site were 29% at 3 years, 26.5%--at 5 and 23.2% at 10 years.

[Prognostic significance of histologic signs in squamous cell carcinoma of the skin of the trunk and extremities]. / Prognosticheskoe znachenie gistologicheskikh priznakov pri ploskokletochnom rake kozhi tulovishcha i konechnostei.

One hundred sixteen cases of squamous cell skin cancer were studied: 83 male and 33 female patients, with their age range being 21-73 yr (mean 50.1 +/- 4.3 yr.). Extremities were the most common localization. The aim of the work was to clarify the correlation between morphologic features and clinical course of the disease. Six out of 14 histologic features studied have demonstrated statistically significant correlation with clinical course. They are: 1) tumour margins; II) form of tumour structures; III) the size of tumour invasion; IV) the presence of tumour cells in the vessels; V) the degree of lymphoplasmocytic infiltration; VI) maximal number of mitoses in one visual field. Three malignancy degrees of squamous cell skin cancer were determined basing on the above-mentioned criteria. Degree I was characterized by 2.8% of metastases and the 5-year survival was 97.2%; for degree II the figures were 26.1% and 85.1%, respectively; and degree III--76.9% and 35.6%, respectively.

[Melanoma of the skin and pregnancy]. / Melanoma kozhi i beremennost'.

Out of 2018 patients, skin melanoma occurred in IO2 (5%) cases during pregnancy. Three-, five- and ten year survival was analysed in the latter cases versus term of pregnancy, abortion and the stage of the disease. Also comparison was made between the said group, another 42 females who developed tumors during lactation period and 599 normally-cycling females of reproductive age who were not pregnant when melanoma appeared (controls). Significantly lower 10-year survival was observed in pregnant patients, as compared with those who were not pregnant (p less than 0.05). Five- and ten-year survivals were significantly lower in cases of stage I tumor during the latter half of pregnancy than in skin melanoma patients who were not pregnant (p less than 0.05). Abortion during the first half of pregnancy was found to produce an adverse effect on prognosis in stage I tumor patients while this effect was reversed in stage II tumor. No significant differences were found between 3-, 5- and 10-year survival in melanoma patients who had pregnancies before the disease and those who had not (p greater than 0.05).

[Complex therapy of melanoma metastases in the lung]. / Kompleksnoe lechenie metastazov melanomy v legke.

The authors present the therapeutic results of 25 patients with melanoma metastases of the lungs: 9 of them received radiotherapy only, 16 radiotherapy combined with i.v. injection of the antitumor antibiotic dactinomycin. The technique of large field irradiation of the lungs was employed as a single exposure (depending on tumor spread) of the entire volume of one or both lungs. The treatment resulted in a decrease of metastases by more than 50% of the initial value in 2 out of 6 patients in the 1st group; in the 2nd group in 16 patients metastases disappeared, in 2 patients they decreased by 50%. Pulmonites prevailed in the group of multiple modality treatment. The authors conclude that dactinomycin raises to a higher power the degree of radiation exposure of melanoma metastases as well as the normal lung tissue.

[Immunological reactions of skin melanoma patients to nonspecific and adaptive immunotherapy]. / Immunologicheskie reaktsii bol'nykh melanomoi kozhi pri nespetsificheskoi i adoptivnoi immunoterapii.

Patients with malignant skin melanoma were given different kinds of immunotherapy; nonspecific immunotherapy with BCG vaccine, adaptive immunotherapy with methotrexate or phytohemagglutinin activated autolymphocytes, and also a combination of polychemotherapy with BCG. The state of cell immunity was determined prior to, during and at the end of the therapy, in accordance with the courses. As a result of the conducted therapy an increased level of cell immunity was observed, that usually corresponded to clinical development of the disease. At the same time, the increase in immune response indices due to continuous administration of BCG vaccine is not related with the clinical course, while the persistent anergy or reduced level of cell immunity during this kind of therapy is a poor prognostic sign.