Therapeutic results in low-rectal cancer patients treated with abdominosacral resection are similar to those obtained by means of anterior resection in mid- and upper-rectal cancer cases.

AIMS: To present the experiences of the Regional Comprehensive Cancer Center in Wroclaw with abdominosacral resection (ASR) carried out in low-rectal cancer patients. METHODS: Rectal cancer patients (n=294) were operated on by the same surgical team using the standardized TME technique between May 5, 1998 and February 23, 2001. Depending on the distance from the anal verge, the primary tumor was removed by means of standard abdominal resection (AR-mid- and upper-rectal cancers) or abdominosacral resection (ASR-low-rectal cancers). The patients who underwent the different operative procedures were comparable in terms of distributions of age, gender, tumor infiltration depth and regional lymph node involvement with no significant statistical difference between the groups. RESULTS: Ninety-seven cases were excluded from the analysis of survival based on exclusion criteria defined. Consequently, 197 cases were left for further analysis, including 154 patients operated on by AR and 43 who underwent ASR. AR and ASR patients did not differ significantly in terms of postoperative morbidity (11% and 14%, respectively), observed (57.1% vs. 60.4%) and relative 5-year survivals (74.3% vs. 73.2%) and the cumulative 5-year local recurrence rate (5.8% vs. 4.7%). CONCLUSION: The combined use of the modern TME technique and the "historical" abdominosacral excision of the rectum seems to give new, potentially attractive perspectives for successful surgical treatment of low-rectal cancers.

Coexistence of parathyroid carcinoma and non-medullary carcinoma of the thyroid.

A case of 35-year-old woman with parathyroid cancer is presented. Five years ago she underwent surgery for follicular thyroid cancer. Parathyroid cancer was evidenced by palpable, solid, irregularly shaped cervical tumor 5 cm in diameter. The patient had severe hyperparathyroidism confirmed by biochemical findings of hypercalcemia reaching 16 mg%, hypophosphatemia and hyperphosphatasemia. Serum parathormone level was 23-fold higher than the norm. These findings were accompanied by polyuria, polidypsia, symptoms of bone damage and renal calcification. After the surgery the patient's condition improved significantly despite persistent hyperparathyroidism. The level of parathormone decreased, but was still 11 times higher than the norm. Two months after the surgery she noticed a single node on her neck. The patient was re-operated for recurrence of parathyroid cancer. Serum parathormone level was then 6-8 times above the norm. Medical treatment with furosemide, calcitonin and biphosphonate resulted in normalization of calcemia and phosphatemia. Further management will aim at localization of foci of hyperactive parathyroid tissue in order to enable radical reoperation. The case is reported because of rare occurrence of parathyroid carcinoma as well as because the carcinoma occurred in a patient who previously had follicular thyroid cancer. There are no reports of coexistence of these two neoplasms in available literature.

Bombesin plasma levels in patients with benign and malignant breast disease.

Some reports suggest a role for bombesin-like peptides in the pathology of breast tumors. Bombesin and related gastrin-releasing peptides have been shown to influence the inositol phospholipid signalling pathway and stimulate growth of some cells, including some human breast cancer cell lines. We measured the plasma concentration of bombesin in 23 breast cancer patients, 32 patients suffering from benign breast disease and in 21 healthy controls. The bombesin concentration in plasma taken from the thoracodorsal vein, in the vicinity of the tumor in breast cancer patients was higher than that in the peripheral circulation (mean +/- SEM, 91.3 +/- 54.3 vs. 40.9 +/- 27.4 pg/ml; p < 0.05). Bombesin concentrations in the cubital vein in breast cancer patients and in those with benign breast disease (61.7 +/- 49.3 pg/ml) was significantly higher than that in the control group (23.7 +/- 5.06 pg/ml; p < 0.05). Our findings suggest storage or synthesis of bombesin-like peptides within the affected breast and may confirm the role of these peptides in the growth of breast tumors.