[Morphometrical and immunohistochemical criteria of prognosis in patients with serous and mucinous ovarian carcinoma]. / Morfometricheskie i immunogistokhimicheskie kriterii prognoza u bol'nykh seroznym i mutsinoznym rakom iaichnikov.

The aim of the study was to investigate the prognostic value of morphometrical features and expression of receptors to progesterone in malignant epithelial ovarian tumours. Surgical biopsy materials of 92 patients with serous and mucinous ovarian cancer were investigated. Tissues stained by hematoxilin and eosin were studied. Morphometry was performed with computer program Axio Vision 3.0. Immunohistochemical characteristics were evaluated with monoclonal progesterone antibodies. It was found that cytomorphometrical features vary in ovarian cancer with different histological structures and the level of differentiation of tumour, and can be used as prognostic factors. We revealed correlation between cytomorphometric factors (carcinoma cell area, total nuclear area, roundness of cell) and risk of recurrences and metastatic spread. In serous cancers presence of progesterone receptors is a favorable factor of prognosis and, as a rule, associates with a high degree of tumour differentiation. In this group of patients 3-year survival reached almost 100% indicating the efficiency of hormonotherapy and chemotherapy.

[Vocational rehabilitation of patients after radical surgery for stomach cancer]. / Trudovaia reabilitatsiia radikalno operirovannykh bolnykh rakom zheludka.

The authors analyse the dynamics of the working capacity of 146 patients with stomach carcinoma according to the type of operative treatment and the character of the work. The results of vocational rehabilitation were best after Billroth I subtotal resection; by the end of a 5-year follow-up period 81.8 +/- 8.2% of the patient who had survived worked (after Billroth II resection 57.8 +/- 7.4%, p < 0.05). After gastrectomy patients resumed work at more later periods. Lethality among parsons who resumed work was independent of the type of operation and was not higher than that among patients who did not work (8.2 +/- 2.3% and 62.6 +/- 2.5%, respectively; p < 0.001). Individuals of intellectual vocations returned earlier to their work after treatment (76.5 +/- 5.9% resumed work in the first 2 years, as compared to 42.1 +/- 5.1% of persons engaged in physical work; p < 0.001). The main tendency was to change to easier conditions of work, with the exception of highly qualified and highly specialized profession. Most of the patients (99 +/- 0.7%) resumed work in the first 4 years after the end of treatment.

[Extension of sick leave for temporary work incapacity of oncology patients]. / O rezul'tatakh prodleniia BTEK srokov vremennoi netrudosposobnosti onkologicheskikh bol'nykh.

The paper deals with an analysis of the end results of extension of sick leaves for 558 cancer patients examined by the Oncological Commission of Medical Experts on Disability, Novosibirsk, in 1988-1991. Extension proved effective in 95.9 +/- 0.8%. The number of patients treated while on sick leave can be increased by the Commission decision with a view to giving them courses of chemotherapy. Such patients might work in between courses. Sick leave should be extended for patients with unclear prognosis and high motivation for work. Extension of sick leave rather than dismissal from work--because of disability, stage I, should be granted on humanitarian grounds to grave cases of incurable cancer.

[Supplementary morphological criteria F anf G in the classification of esophageal cancer by the TNM system]. / Dopolnitel'nye morfologicheskie kriterii F i G v klassifikatsii raka pishchevoda po sisteme TNM.

Additional criteria are introduced for the prognosis of esophageal carcinoma: anatomical form of growth (F) and the degree of carcinoma differentiation (G). These conclusions are drawn basing on long-term results of treatment of 302 patients. These additional criteria help to make a proper choice of treatment. The best results may be expected under the following combination--T1P1-2N0M0F1G1, 5-year survival in these patients was 69.8%. Unfavourable results were in the group of radically treated patients with the following combination T3P3N1M0F1-3G3bv, 5-year survival being 7.8% only.

[An analysis of the work activities and survival of patients operated on for stomach cancer]. / Analiz trudovoi deiatel'nosti i vyzhivaemosti bol'nykh, operirovannykh po povodu raka zheludka.

The paper deals with the analysis of dynamics of working activity of 146 radically treated gastric cancer patients examined by the Oncological Commission for Ability Expertise of Novosibirsk in 1984-1988 and then followed for 2-5 years. The percentage of patients returning to work was the highest during the first and third years posttreatment. This was attributed to extension of temporary invalidity period and rehabilitation of group 2 invalids, respectively. Lethality among patients returning to work was 8.2 +/- 2.3% as compared to 62.6 +/- 2.5% in a group of 385 patients who did not work. Labor activity did not adversely influence the clinical course of disease. The unfavorable course was attributed to biological properties of tumor such as low degree of differentiation and infiltrative pattern of growth.

[The characteristics of the combined and complex treatment of colloid rectal cancer]. / Osobennosti kombinirovannogo i kompleksnogo lecheniia kolloidnykh rakov priamoi kishki.

The effectiveness of combined (surgery + radio- or chemotherapy) or complex treatment for colloidal cancer of the rectum was evaluated in 180 patients with such tumors which included mucinous adenocarcinoma, mucinous cancer and signet-ring cell cancer. Five-year survival rate in 49 patients treated with adjuvant chemo- and/or radiotherapy (39.9 +/- 9.1%) did not differ significantly from that in cases undergoing surgery alone (39.1 +/- 4.7%) (p > 0.05).

[Adenogenous cancer of the esophagus]. / Adenogennyi rak pishchevoda.

The authors consider the most promising long-term results to be achieved in treatment of patients with highly differentiated adenocarcinomas, size of the tumor up to 60 cm and growth of the tumor into the muscle level. The prognosis was doubtful in patients after radical operations but having average degree of differentiation of adenocarcinomas, with size more than 60 cm and growth into the whole esophagus wall. The prognosis was unfavorable in patients with poorly differentiated adenocarcinomas. Metastatic involvement of lymph nodes does not make the prognosis worse.

[Metastatic involvement of regional lymph nodes and long-term results of the treatment of patients with cancer of the thoracic part of the esophagus]. / Porazhenie metastazami regionarnykh limfaticheskikh uzlov i otdalennye rezul'taty lecheniia bol'nykh rakom grudnoi chasti pishchevoda.

The patients who underwent the radical operations for cancer of the thoracic esophagus were subdivided into three groups: group 1--patients with no metastatic involvement of the regional lymph nodes (N0); group 2--with enlarged regional lymph nodes because of their hyperplasia, but without metastatic involvement (NX); group 3--with metastatic involvement of the regional lymph nodes (N1). The best results of 5-year survival after radical operation (50.2%) were noted in patients with a tumor size less than 3 cm, infiltration of only muscular layer, high degree of cancer differentiation, without metastatic involvement of regional lymph nodes. In presence of metastases, the 5-year survival was 6.01%. Discovering at operation the enlarged lymph nodes is a poor prognostic sign, 5-year survival of these patients do not exceed 9%.

[The prognostic significance of the anatomical forms of esophageal cancer]. / Prognosticheskoe znachenie anatomicheskikh form raka pishchevoda.

Among the great variety of anatomic patterns of esophageal cancer growth, three basic patterns--exophytic, mixed and endophytic--should be distinguished. Anatomic pattern of growth is one of the basic prognostic criteria for tumor stage assessment. This finding is supported by five-year survival evidence for cases of radical surgery: 58.8 +/- 10% with exophytic form, 16.6 +/- 10%--ulcerative infiltrative and 3.3 +/- 6% with diffuse infiltrative pattern of tumor growth.

[Recurrent nonorganic tumors of the lesser pelvis]. / Retsidivy neorgannykh opukholei malogo taza.

The authors' findings on 16 cases of small pelvis nonorganic tumor recurrence are presented and relevant recommendations on diagnosis and treatment are given.

[Clinico-morphological characteristics of marginal epithelial ovarian tumors]. / Kliniko-morfologicheskie osobennosti pogranichnykh épitelial'nykh opukholei iaichnikov.

Clinico-morphological features of 228 proliferating epithelial ovarian tumors of various histological patterns were studied. The group under study consisted of 135 serous (59.2%), 54 mucinous (23.7%) and 39 endometroid cystadenomas (17.1%). These tumors spread by implantation only. Metastases were registered in 20.2% of cases. Their incidence increased significantly in younger patients of reproductive age and in those with bilateral lesions, ascitis, cystic-solid and papillary types of tumor growth, mucinous tumors and invasive neoplasms. A correlation was established between the degree of tumor proliferation and the clinical course of the disease: 79.4% of patients of the atypical proliferation group revealed apparent manifestations of malignancy.

[Ultrastructural characteristics of endometrioid and serous ovarian adenocarcinomas]. / Ul'trastrukturnye osobennosti éndometrioidnykh i seroznykh adenokartsinom iachnikov.

Analysis of the fine structure of glandular-solid tumors of the ovaries of endometrioid and serous genesis was carried out for specification of criteria for differential diagnosis of these tumors. The specific ultrastructural features (homogeneous or heterogeneous cell composition, the presence or absence of villi, tonofibrilos, glycogen inclusions) were shown to be present in areas of formation of glandular structures. Diagnosis of solid variants of endometrioid and serous carcinomas should also take into consideration the rate of occurrence of such ultrastructural signs typical of malignant cells as deep invaginations of the nuclear membrane, extended perinuclear space, increased number of nucleoli and macrosegregation of their content, increased number of myelin figures, polymorphism of mitochondria, cut-up cellular surface, well-developed laminar complex, and hypertrophy of the cytoplasmic reticulum. In serous carcinomas these features occur much more frequently.

[Clinico-morphological characteristics and results of treatment of endometrioid cystadenocarcinoma of the ovary]. / Kliniko-morfologicheskie osobennosti i rezul'taty lecheniia éndometrioidnoi tsistadenokartsinomy iaichnikov.

Clinico-morphological peculiarities of endometrioid cystadenocarcinoma of the ovaries (105 cases) were compared with those of a more frequent serous one. Hyperestrogenism was more frequent in endometrioid cystadenocarcinoma, metastases, ascites and hydrothorax developing less frequently. Immediate and long-term results in endometrioid cystadenocarcinoma were better than in cases of serous one. When hormone-producing, both tumors metastasized less frequently and 5-year survival rates in such cases were relatively higher. Progestin treatment was effective in cases of endometrioid cystadenocarcinoma, particularly, in those of hormone-producing form.