[Surgical management in advanced cases of sympathoma]. / Postepowanie chirurgiczne w zaawansowanych przypadkach zwojaka zarodkowego wspólczulnego u dzieci.

In advanced stages of neuroblastoma, surgical management is limitedly indicated. In majority of cases (25/26 in own material) surgical procedures were performed for the sake of receiving samples for pathological examination. Surgical treatment was very rarely indicated. The only one case of neuroblastoma in stage IV that was indicated to surgical treatment after complete remission of metastases, the child died in spite of radical excision of the primary tumour. The reason of that was new metastases in distant lymphonodes which appeared when complex therapy was finished. A little larger indications for surgery exist in stage IV-S of neuroblastoma, which gives better prognosis than stage IV. Anyhow indications for surgery in stages IV and IV-S have to be given very cautiously. Histopathological evaluation can be done on the basis of fine needle biopsy, that is much safer for the children.

[Role of chemotherapy in the treatment of Wilms' tumor in children]. / Rola chemioterapii w leczeniu guza Wilmsa u dzieci.

In the years 1962-1976, 168 children with nephroblastoma (Wilms Tumour) were treated in the Clinical Department of Child Oncology of the Institute of Mother and Child in Warsaw. In 150 cases, independently from surgery and radiotherapy, chemotherapy was performed. Our material was divided into 5 groups: a) without chemotherapy, b) chemotherapy with different drugs, c) chemotherapy with 1 course of Actinomycine D, d) chemotherapy with several courses of Actinomycine D, e) chemotherapy according to SIOP Trial. The results with reccurency free survival are as follows: a) 22,2%, b) 24,1%, c) 28,1%, d) 46,6%, e) 56,6%. In our material the best results were received with SIOP Trial chemotherapy.

[Radioimmunological monitoring of the treatment of malignant neoplasms in childhood]. / Radioimmunologiczne monitorowanie leczenia nowotworów zlosliwych wieku dzieciecego.

In 56 cases of children with tumours, the level of alpha-fetoprotein (AFP) was established with radio-immunological method. There were 15 children with neuroblastoma, 13 with ovarian tumours, 14 with sacro-coccygeal tumours, 7 with tumours of liver and 7 with tumours of testis. The level of AFP was elevated in all children with hepatoblastoma, carcinoma embryonale, and malignant teratoma. Monitoring was performed in 15 children with tumours mentioned above. Usefulness of evaluation of AFP level in blood serum in these tumours has been confirmed by diagnosis. In effective treatment of these tumours, AFP level has fallen down to normal. Its rising up again prognosed tumour's relapse several months before.

[Value of polychemotherapy in the treatment of children with neuroblastoma]. / Ocena wielolekowej chemioteraph w leczeniu neuroblastoma u dzieci.

The authors present a group of 10 children with neuroblastoma treated with multidrug chemotherapy. 5 children were treated according to VCAD protocol and 5 children according to COMP protocol. The VCAD protocol seems to be useful in less advanced stages of neuroblastoma (stage I and II after incomplete excision) as a prophylactic chemotherapy and in stage III with parallel irradiation of tumoral mass. Chemotherapy with COMP protocol can provoke palliation and prolongation of survival time, and sometimes significant remission. Having support of the treatment with adequate irradiation it is possible to restrict tumoral mass and consolidate the result od chemotherapy.

[Sacrococcygeal teratomas in children treated at the Oncological Clinic of the Mother and Child Institute in Warsaw]. / Potworniaki okolicy krzyzowo-guzicznej u dzieci w materiale Kliniki Onkologii Dzieci i Mlodziezy Instytutu Matki i Dziecka w Warszawie.

During the years, 1962 through 1975, 27 children with sacrococcygeal teratomas were seen at the Oncological Department of the National Research Institute for Mother and Child in Warsaw. 13 teratomas were benign and 14 were malignant. Surgical removal through a sacral approach was the basis of the treatment. In the presacral tumors with great diameter two-phase method was performed (the first phase--trans-abdominal excision of the tumor and the second phase--excision of remnant tumor's pedicle with coccygeal bone resection). Monodrug chemotherapy (Cyclophosphamide, Actinomycin D) in malignant tumors was without effect. In the group of benign teratomas are alive 11 children, in the group of malignant teratomas only one child survived. Some profits are expected from the multidrug chemotherapy ( Methotrexate , Cyclophosphamide, Actinomycin D) associated with radiotherapy, this can make operable primarily inoperable tumors.

[Ovarian neoplasms in girls treated at the Oncological Clinic of the Mother and Child Institute in Warsaw 1970-1975]. / Nowotwory jajnika u dziewczat leczonych w Klinice Onkologii Dzieci i Mlodziezy Instytutu Matki i Dziecka w Warszawie w latach 1970-1975.

Sixteen girls with ovarian tumors treated in the years 1970-1975 in the Oncological Department of the National Research Institute of Mother and Child were studied. 6 tumors were benign ( cystis dermoidalis --5 cases, cystadenoma mucinosum --1 case) and 9 tumors were malignant (dysgerminoma--6 cases, teratoma malignum --3 cases and neoplasma malignum epitheliale --1 case). Middle age of girls with ovarian tumors was 11 years. The commonest signs were abdominal pains, abdominal discomfort and presence of tumor in abdomen. Benign tumors were treated surgically by unilateral adnexectomy in 5 cases and bilateral adnexectomy in 1 case. Surgery and radiotherapy were basic treatment in malignant tumors in 6 cases, 3 cases of malignant tumors were treated by surgery, radiotherapy and chemotherapy, one case of malignant teratoma in stage Ia was treated only surgically. 6 girls with malignant tumors survived without evidence of the disease 33 months and longer. The best results were obtained in dysgerminomas even in stage III of disease. In teratoma malignum group survival were obtained only in the stage Ia of the disease.