Cancer

Early clinical experience suggests that low-molecular-weight heparin has an important role in the prevention of recurrences of venous thrombosis in cancer patients.

The authors report an unusual case of neutropenic enterocolitis in a patient with colorectal carcinoma treated with 5-fluorouracil and leucovorin. The diagnosis and treatment of this potentially fatal condition are discussed.

The cystic and pericholedochal lymph nodes are the initial sites of lymph node metastasis in gallbladder carcinoma. Although lymph node disease carries a poor prognosis, >50% of such cases with metastases limited to level pN1 lymph nodes can be cured by radical surgery.

The oncogenes c-myc, bcl-2, c-erb B-2, and c-jun are frequently expressed in human gastroenteropancreatic neuroendocrine tumors (GPNTs). The expression of these oncogenes may represent pathogenic events in the generation, malignant transformation, and progression of GPNTs. The immunohistochemical evaluation of cell kinetics in GPNTs by proliferating cell nuclear antigen might be a useful adjunct to conventional diagnostic procedures.

Clinical histories and physical examinations appear to be the most useful follow-up surveillance tests in patients with small cell lung carcinoma whose disease is in complete remission after planned therapy. In this study, routinely obtained chest X-rays signaled disease recurrence in an additional 12% of patients whereas routinely obtained blood tests appeared to have minimal utility.

A review of 322 cases of primary germ cell tumors of the mediastinum showed that the majority occurred in young adult men, with teratomatous and seminomatous lesions being the most frequently encountered. Clinical and pathologic staging are valuable parameters for the assessment of prognosis.

A study of 120 patients with primary mediastinal seminoma showed that the majority of the lesions followed a relatively indolent clinical course. Patients who developed metastases and died of their tumors had presented with advanced stages of disease or were in the age group >37 years.

A study of 64 cases of primary yolk sac tumor, embryonal carcinoma, choriocarcinoma, and combined nonteratomatous germ cell tumors of the mediastinum confirmed their highly aggressive nature and showed that clinical and pathologic staging correlate with prognosis.

A retrospective clinicopathologic study of 250 patients with idiopathic (primary) osteomyelofibrosis was performed to identify independent features with relevant prognostic impact and the disease specific loss in life expectancy. Age, anemia, and leukocyte and platelet counts, but not the degree of myelofibrosis, were revealed as the most important parameters of predictive value.

Analysis of mammographic outcomes in menstruating women ages 40-44 years on entry into the Canadian National Breast Screening Study revealed a statistically significant increase in the risk of experiencing a false-negative mammogram when mammograms were performed in the luteal phase of the menstrual cycle compared with the follicular phase. This effect was observed only in women who had ever used estrogen.

In a case-control study involving 1086 Chinese women (204 cases and 882 controls) ages 45 to 69 years, the risk of breast carcinoma was strongly associated with increasing central obesity (waist to hip ratio) and height. Reproductive and menstrual factors significantly related to breast carcinoma risk included number of deliveries, age at last delivery, age at menopause, hormone replacement therapy, and breast feeding. Changes in lifestyle related to caloric intake and declining fertility may partly explain the rapid rise in the incidence of breast carcinoma in Singapore.

Tamoxifen administration initiated 1-6 weeks postradiation does not compromise local control or cosmetic outcome in the conservatively treated breast. In fact, tamoxifen may confer a modest enhancement of local control.

In the current study, endometrial carcinomas with a high microvessel count were usually of high histologic grade, had more myometrial invasion and lymph-vascular space invasion, and demonstrated a worse prognosis.

Men with prostate carcinoma surviving ≥10 years have an excess mortality compared with age-matched controls. This excess mortality ceases during extended follow-up.

Immunoreactivity for p34^cdc2 protein in prostatic adenocarcinoma correlates with high Gleason's grade, advanced pathologic stage, nondiploid DNA content, metastasis, and independently predicts disease recurrence after radical prostatectomy.

Unfavorable locoregional prostate carcinoma can be recognized on the basis of pretreatment serum prostate specific antigen level, T category, and Gleason's grade without specific concern for pelvic lymph node status. Combined radiation and androgen ablation for patients with unfavorable disease results in substantial improvement in disease control compared with the use of either treatment alone.

Expression of the endogenous β-galactoside-binding protein galectin-3 is significantly associated with the grade of malignancy of primary human brain tumors, and is also associated with metastases to the central nervous system.