Recurrence and survival analyses of 1,115 cervical cancer patients treated with radical hysterectomy.

Many clinicopathological factors of cervical cancer are still controversial in their prognostic significance. The case records of 1,115 patients who received radical hysterectomy at the Veterans General Hospital, Taipei, from 1980 to 1989 were collected to evaluate prognosis-related factors by univariate and multivariate analyses. The pathology was reviewed retrospectively by one pathologist. Ten parameters known to be prognostic in the literature were included for analysis. Univariate analysis showed that patients with all these factors had higher recurrence rates. However, when the effects of parametrial invasion, progressive stage and stromal invasion were weighed against the presence of lymph node metastasis, their influence on recurrence became unimportant. Nevertheless, these factors still influenced prognosis when there was no lymph node metastasis. Multivariate analysis of both recurrence and survival time in the patients with squamous cell carcinoma shared a consensus that pelvic lymph node metastasis and deep stromal invasion were significant risk factors. We conclude that these simplified and consistent results obtained by multivariate analysis provide a basis for subclassification of patients to predict prognosis and change therapy.

Antiplatelet drugs in arterial thrombosis: a review.

The thrombotic process, basic mechanisms of action of antiplatelet drugs, and clinical trials with platelet inhibitors are reviewed. The role of prostaglandins in platelet reactions and the mechanisms of aspirin's, dipyridamole's and sulfinpyrazone's inhibition of platelet function are discussed. Clinical studies of the use of these three drugs, alone or in combination with each other or with anticoagulants, for the treatment of thrombotic disorders associated with valvular heart disease, prosthetic heart valves, cerebral vascular disease (e.g., transient ischemic attacks), coronary artery diseases (including myocardial infarction), peripheral vascular disease, renal disease and renal allograft rejection are reviewed and evaluated. Clinical evidence suggests that antiplatelet drugs are useful in preventing thromboembolism associated with coronary and cerebral vascular disorders. In peripheral vascular and renal diseases and in renal allografts, their benefits have not been proved. Further controlled clinical studies of the preventive use of these drugs for arterial thrombosis are needed.