Competing mortality contributes to excess mortality in patients with poor-risk lymph node-positive prostate cancer treated with radical prostatectomy.

BACKGROUND: Factors predicting survival in men with lymph node-positive prostate cancer are still poorly defined. PATIENTS AND METHODS: 193 prostate cancer patients with histopathologically proven lymph node involvement with a median follow-up of 7.3 years were studied. 94% of patients received immediate hormonal therapy. Kaplan-Meier curves were calculated to evaluate overall survival rates and compared with the log-rank test. Cumulative disease-specific and competing mortality rates were calculated by competing risk analysis and compared with the Pepe-Mori test. Cox proportional hazard models were used to determine the independent significance of predictors of all-cause mortality. RESULTS: Age (70 years or older vs. younger), Gleason score (8-10 vs. 7 or lower) and the number of involved nodes (3 or more vs. 1-2) were identified as independent predictors of all-cause mortality. When patients with 0-1 of these risk factors were compared with those with 2-3 risk factors, all-cause (rates after 10 years 21% vs. 71%, p < 0.0001), disease-specific (12 vs. 37%, p = 0.009) and competing mortality (9 vs. 33%, p = 0.02) differed significantly. CONCLUSIONS: Some of the excess mortality in patients with poor-risk lymph node-positive prostate cancer may be attributed to increased competing mortality, possibly caused by an interaction between comorbid diseases and hormonally treated persistent or progressive prostate cancer.

The exodus of German dermatologists and their contributions to their adopted countries.

This study reviews the establishment of dermatology in Germany, the exodus of German dermatologists during the Third Reich, and their contribution to dermatology in the United States and European countries.

[The fate of the professors of the medical Faculty of Breslau after the expulsion 1945/46]. / Das Schicksal des Lehrkörpers der Medizinischen Fakultät Breslau nach der Vertreibung 1945/46.

The University of Breslau was one of the most important universities in Germany in the first half of the 20th century. Breslau was the capital of the state of Silesia which became Polish territory. The university was closed after World War II. There were attempts to transfer the entire Medical Faculty to an established German university in Heidelberg, Leipzig, and Mainz, but these efforts failed. All 18 full professors from Breslau tried to get a university position; 16 moved to the western zones while two were in the eastern zone of Germany. Only 11 professors were successful in obtaining a position. Factors determining who was successful were evaluated. The scientific or political background of the professors played much less of a role than informal networking. Detailed biographies of the 18 full professors complete this report.

Intralesional recombinant interferon beta-1a in the treatment of basal cell carcinoma: results of an open-label multicentre study.

Although effective conventional therapies are available to treat basal cell carcinoma (BCC), undesirable side effects, including scarring, and in some cases permanent damage, often occur in problematic areas of the body, especially around the eyes, mouth, and cartilage of the nose and ears. In previous studies, intratumoural injection of recombinant interferon beta-1a (rIFN-beta-1a) has been shown to result in complete remission (CR) in 47% to 86% of patients with BETACC. The primary objective of the study was to determine the response rate to rIFN-beta-1a, in a larger BETACC patient population. Secondary objectives included evaluating the effect of tumour type/size on response as well as residues, cosmetic results, and relapse rate after CR. The safety profile of intratumoural rIFN-beta-1a in BETACC patients was also evaluated. This was an open-label, multicentre study involving 139 patients with BETACC (diameter between 5.0 and 20 mm). Intratumoural injections of rIFN-beta-1a (1.0 x 106 IU) were administered three times a week for 3 weeks. The response was determined 16 weeks after start of treatment and the status of patients was followed for up to 5 years. At 16 weeks, the response rate to intratumoural rIFN-beta-1a was 66.9% (95% CI, range 58.2-74.8%). There was no significant difference between the response rates for patients with solid or other BETACC tumour types. Similarly, tumour size did not significantly affect the response rate. The cosmetic result of treatment was rated as good or very good in 83% of responders. The relapse rate after CR was 4.5% (median follow-up 2 years). All patients showed local inflammatory reactions, which were generally considered to be the adverse drug reactions (ADRs). Systemic ADRs mostly consisted of flu-like symptoms and occurred in 32/139 patients. No ADRs were considered to be the serious. These results show that intratumoural injections of rIFN-beta-1a are effective in the treatment of BETACC in the majority of patients. In addition, rIFN-beta-1a is safe and generally well tolerated. rIFN-beta-1a represents an effective alternative treatment for BETACC.