Postoperative radiotherapy in gastric cancer.

Surgeons in Poland are very skeptical about the positive role of adjuvant irradiation in patients with gastric cancer. A retrospective study of 21 patients with operable gastric cancer referred for irradiation to Cancer Centre in Warsaw between December 1984 and December 1991 was performed. Patients were qualified to receive adjuvant treatment because of bad prognostic factors--nonradical surgery (10 patients), infiltration of entire thickness of gastric wall (13 patients), and metastases in regional lymph nodes (9 patients). All patients were in good condition. They were treated by either telecobalt 60 unit or linear accelerator using 9-15 MeV photons. The total dose to the gastric bed and lymphatic was 46-50 Gy in 25 to 28 fractions, 5 days a week. The tolerance of treatment was good. None of these patients received 5-FU either during irradiation or as maintenance therapy. We have obtained more than 50% overall survival rate at 3 years. Median survival was 27 months and median recurrent-free interval 27 months. Local recurrence was found in four patients, distant metastases in five patients. In the group of 10 patients with nonradical surgery, 5 are alive without evidence of disease from 2 up to 7 years after treatment. Our preliminary results and good tolerance of treatment seem to support the beneficial role of adjuvant radiotherapy after gastrectomy in patients with risk factors of locoregional cancer recurrence.

[Evolution of post-traumatic hematoma of the liver monitored by ultrasonography]. / Ewolucja pourazowego krwiaka watroby monitorowana ultrasonograficznie.

The results of 20 months of follow-up of posttraumatic hepatic haematoma are presented. The haematoma developed as a result of blunt abdominal trauma and was diagnosed intraoperatively. Monitoring was based on ultrasonography. A significant change in the echographic pattern and size of the haematoma indicated its organization. The purpose of the study was calling attention to the ultrasonographic findings in hepatic haematoma in relation to the time after trauma. It is worth stressing that hepatic haematoma healed well although it had not been managed during the operation (even not drained).