Serial immunocytologic analysis of blood for tumor cells in two patients with neuroblastoma

Article Abstract:

The response of a cancer patient to therapy is usually based on clinical signs and symptoms. A complete response is suggested by the disappearance of clinical signs and symptoms of disease, although microscopic evidence and subclinical signs may exist. It would be advantageous to have a noninvasive method of monitoring the response of patients to therapy, as well as a method of detecting tumor recurrence as early as possible. Modern imaging techniques have contributed greatly in this regard. In the case of neuroblastoma, the measurement of urinary catecholamines may be helpful as well, but these tests are not always sensitive enough. One method that may be highly sensitive is the identification of individual neuroblastoma cells floating in the blood, as the shedding of such cells may be one of the first and most sensitive indicators of tumor recurrence. Conversely, the disappearance of such cells may be an excellent indicator of response to treatment, particularly when suspicious masses remain visible by imaging techniques such as magnetic resonance imaging. Until recently, the examination of blood for neuroblastoma cells has been impractical. Culturing the cells is too elaborate and time-consuming, and visually identifying the cells under the microscope is fraught with opportunities for error. The advent of monoclonal antibody technology may make the detection of these cells in the blood feasible. Using antibodies that are highly specific for neuroblastoma cells it is possible to confidently identify a small number of neuroblastoma cells among an overwhelming number of normal blood cells. This method was used to monitor two children with neuroblastoma. In one case, the examination of the blood using the monoclonal antibodies documented the persistence of neuroblastoma cells; in the other, the technique documented the disappearance of these cells. In both cases, the indications of the blood test were confirmed upon autopsy. The authors suggest that for patients with disseminated neuroblastoma, immunocytological monitoring of the blood should become a standard technique to be performed along with the more conventional methods of patient monitoring. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Evaluation, Cancer invasiveness, Neuroblastoma

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Survival analysis of 378 surgically treated cases of laryngeal carcinoma in South Sardinia

Article Abstract:

The frequency of laryngeal cancer varies within Italy, with northern areas having a higher rate compared with the southern areas and the island of Sardinia. The difference has been attributed to alcohol consumption and tobacco use. The characteristics of laryngeal cancer in patients on the island of Sardinia, an area of low-risk, were analyzed by reviewing 378 surgically treated cases. The five-year survival rate was 61 percent. Since the 10-year survival was 51 percent, it appears that at five years a plateau of survival has been reached. Normally, the stage at which a tumor is diagnosed is a significant prognostic factor, with patients in earlier stages having better survival rates. However, among patients who delayed seeking medical treatment after noticing symptoms, there was no statistically significant influence on survival. The stage of cancer was not as important a prognostic indicator as was the ulceration of the cancer; the survival of patients with ulcerated tumors was roughly 40 percent, in contrast to a better than 70 percent survival rate achieved by those without ulceration. The precise location of the cancer and the type of surgery performed were not important factors in predicting patient outcome. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Laryngeal cancer

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