[Gestational trophoblastic tumors--a report of experiences]. / Gestationsbedingte Trophoblasttumoren--Ein Erfahrungsbericht.

The paper reports on clinical experiences of treatment of 58 patients with Gestational Trophoblastic Tumors (GTT), collected between 1978 and 1991. According to the Bagshawe-Score, 29 patients were at low-risk, 10 patients were assigned to the high-risk category. Among 29 metastatic cases, 5 patients had brain metastasis. In 33 patients, treatment started from the time of diagnosis. In 25 cases, treatment was initiated at other hospitals and patients were referred only after various unsatisfactory treatment measures. Low-risk patients were mainly subjected to methotrexate and folinic acid. Patients at medium-risk received a sequential chemotherapy. In high-risk patients we preferred the CHA-MOCA- or the EMA/CO-regimen. Treatment was successful in 91.4% of patients including all cases of low- and medium-risk. Five patients with brain metastases received systemic chemotherapy combined with intrathecal application of methotrexate and radiotherapy. Three of them could be cured. Patients taken from other hospitals more often underwent primary hysterectomies prior to systemic chemotherapy (40% versus 3%) and more often developed drug resistant tumors due to inadequate primary treatment. Five patients (8.6%) died from their disease, but only one of them received primary treatment in our department. Thus, the outcome (1/33 compared to 4/25) was significantly better for patients treated primarily at specialized centers.

[Microinvasive stage Ia cancer of the uterine cervix--results of a multicenter clinic based analysis]. / Mikroinvasives Karzinom der Cervix uteri Stadium Ia--Ergebnisse einer multizentrischen Klinikbezogenen Analyse.

A retrospective multicentre study to investigate diagnosis, treatment and end results of treatment of cervical cancer stage Ia, was carried out in 6 departments of gynaecological oncology. After reclassification by a reference pathologist, among the 936 cervical cancer cases primarily diagnosed and treated as stage Ia between 1970 and 1980, only 530 (56.6%) met the criteria of microinvasive cancer stage Ia. Misclassifications concerned all participating centres with statistically significant differences amongst them. Overdiagnosis (reference diagnosis only CIN I-III, 42.5%) was more frequent than underdiagnosis (reference diagnosis stage Ib--0.9%). In comparison to 1970-74, in the period 1975-80 a significant increase of cases detected asymptomatically (86.5%) was observed. The percentage of cases primarily diagnosed by cone biopsy, also increased significantly and amounted to 71.2%. Patients with cervical cancer stage Ia were most frequently treated by surgery alone (93.2%). Radiotherapy alone did not play any important role (5.7%). There were only a few cases treated by combined surgery and radiotherapy (5.7%) with a decreasing trend over time. Women under the age of 45 years were significantly more frequently treated by the conservative method (cone biopsy, simple hysterectomy) than older ones, without any significant relation between depth of invasion and radicality of treatment. A total of 19 (14 local, 5 lymph node) recurrences were diagnosed between 9 and 110 months after primary treatment. Local recurrences could be observed more frequently after limited than extended treatment. There was no significant relation between depth of invasion and frequency of recurrences, but the latter were significantly increased in cases with histologically proven invasion of blood or lymph vessels.(ABSTRACT TRUNCATED AT 250 WORDS)

[Epidemiology of cervical carcinoma and screening activities in GDR (author's transl)]. / Epidemiologie des Zervixkarzinoms und Sereeningaktivitäten in der DDR.

In the GDR, cervical carcinoma is considered as one of the most important malignant neoplasias for its high incidence and age distribution. It offers, however, optimum prerequisites for effective cytological mass screening for primary and secondary prevention. Reference is made to typical screening effects in an attempt to analyse activities for early diagnosis which are highly differentiated by regions within the GDR. Systematic expansion of capacities for cytological examination is essential to the control of cervical carcinoma. Medical attention can be further improved by wider use of specialised prebioptic diagnosis in connection with all suspicious and positive screening findings.

[Antineoplastic chemotherapy for cervical carcinoma (author's transl)]. / Antineoplastische Chemotherapie beim Zervixkarzinom.

The effectiveness of antineoplastic substances on cervical carcinoma is insufficient. While combined chemotherapy was found to be more effective than monotherapy, satisfactory results were not achieved either. When it comes to recurrent or metastatic cervical carcinoma, antineoplastic chemotherapy, therefore, is not recommended unless all surgical and radiotherapeutic means have been tried with no success. Benefit to the patient and expected molestation should be carefully weighed, before a decision is made.