Long-term results of a combined modality approach in treating inflammatory carcinoma of the breast

Article Abstract:

Inflammatory carcinoma of the breast is an aggressive cancer with an extremely poor prognosis. This cancer usually has an acute onset with symptoms of redness, edema, and local heat of the breast; a mass is palpable in about 60 percent of cases. Patients are traditionally treated by only mastectomy (surgical removal of the breast), resulting in an average survival of 2.4 to 25 months. The five-year survival rate is 2.4 percent. This cancer has a high incidence of local and systemic spread, but better results have been reported for patients treated with system-wide chemotherapy followed by radiation therapy. A report is presented of 28 women with inflammatory breast cancer initially treated with systemic chemotherapy (cyclophosphamide, doxorubicin hydrochloride, and 5-fluorouracil). Women ranged in age from 30 to 88, with an average age of 50. A good response to chemotherapy was obtained in 22 women, and 21 also underwent mastectomy; all 21 women had residual cancer spread to the lymph nodes of the armpit. Following surgery, the women were again given same chemotherapy. If cancer recurred during follow-up, the patient was treated with radiation therapy and/or chemotherapy. The six women who did not respond to chemotherapy initially were treated with radical radiation therapy, followed by chemotherapy. Disease-free survival for the 17 women without evidence of cancer spread at the time of diagnosis ranged from 5 to 84 months, with an average of 30 months. Overall survival was 7 months to over 10 years (average of 32 months); survival at five years was 18 percent. Survival for the 11 women with distant cancer spread ranged from 4 to 14 months. These results indicate that women with inflammatory breast cancer, but without clinical evidence of cancer spread, may achieve improved survival if treated initially by systemic chemotherapy, followed by mastectomy, and then more chemotherapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Breast cancer, Chemotherapy, Combined modality therapy

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Prognostic factors in squamous cell carcinoma of the larynx

Article Abstract:

Many factors influence a person's ability to overcome a serious disease such as cancer of the larynx, or voice box. A retrospective analysis of the medical records of 152 patients with squamous cell carcinoma of the larynx (diagnosis was made between January 1, 1976 and December 31, 1986) was performed to study the effect of 12 factors on disease-free survival and overall survival rates. The factors studied included age, gender, race, site of primary tumor, degree of metastases (cancer spread to distant sites in the body) at diagnosis, pathology, recurrence, phase of disease (early or advanced), and type of treatment received. Undocumented information about personal history, such as smoking and drinking habits, was not included. The patients, whose ages ranged from 36 to 85 years (average was 61 years) were 118 males (66 white and 52 black) and 34 females (18 white and 16 black). No significant differences were observed in the survival rates based upon black versus white race, age of under 60 versus 60 and above, local versus regional recurrence of cancer, or treatment by surgery versus radiation. However, women were more likely than men to experience better long-term disease-free survival. Other factors, in addition to male gender, that appeared to correlate with a poorer prognosis were recurrence; advanced phase (late stage) of the disease at diagnosis; degree of local invasion and metastases; extent of ulceration; and site of the primary tumor. This study was conducted to identify prognostic factors that could help in forecasting the outcome for laryngeal cancer patients. This has been difficult to do because the behavior of the tumor can be vastly different depending upon the patient, but the authors suggest that if a national, and perhaps an international, registry of head and neck tumors were organized, the management of these cancers might become more effective. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cancer, Laryngeal cancer

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Flow cytometric DNA analysis of primary and concurrent metastatic squamous cell carcinoma of the head and neck

Article Abstract:

Flow cytometry is a modern technique used to determine the amount of DNA in cells. Differences in DNA content, histology and pathology may be significant between primary carcinoma and metastatic cells and may provide information about the relationship between these cells and the progression of the tumor. Primary refers to the original tumor, whereas metastasis refers to the tumor caused by the growth of primary cells that migrated to another site in the body. Flow cytometry studies on specimens of squamous cell carcinoma of the head and neck, as well as their corresponding metastases, from 28 patients (19 males and 9 females; average age 60 years) revealed no differences in DNA index. Furthermore, histological evaluation (percentage of malignant cells) and pathology screening (degree of cell differentiation) were not different in the two cell populations. Although no differences were observed in the DNA content of primary and metastatic squamous cell carcinoma samples in this study, following additional refinement flow cytometry might prove to be a useful tool for identifying the stage of disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Measurement, Physiological aspects, DNA, Flow cytometry, Head and neck cancer

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