Cancer

The classification of fibrosarcomas introduced by Stout 50 years ago and published in Volume 1 of Cancer in 1948 set the foundation for the classification, grading, and staging of all soft tissue sarcomas. In this article, the author reviews the progress made during the past 50 years in the understanding of the morphology and natural history of malignant tumors of fibroblasts.

Among estrogen receptor positive patients treated with breast-conserving surgery and radiotherapy, tamoxifen reduces the rate of ipsilateral breast carcinoma recurrence by a factor of 2-3. Whether this degree of protection will allow selected low risk patients to be treated without breast irradiation is a subject for further study. See also pages 2204-11.

A consensus panel reviewed the literature regarding therapy for hormone-refractory prostate carcimona and recommended further Phase III trials building on previous Phase III trials with mitroxantrone/hydrocortisone, estramustine/vinblastine, and strontium⁸⁹. Endpoints of such future trials could be survival, tumor response, or palliative response rate.

Histopathologic and immunohistochemical analysis of an esophageal carcinosarcoma that was comprised of squamous cell carcinoma cells and spindle-shaped sarcomatous cells accompanied by transitional features suggested that those two components originated from a single clone. This postulation was confirmed by the finding that these two components each produced granulocyte-colony stimulating factor.

Borrmann type 4 gastric carcinoma is characterized by the multiple and simultaneous expression of c-met, autocrine motility factor receptor, and urokinase-type plasminogen activator receptor.

A high prevalence of comorbidity in older-aged colon carcinoma patients is described with implications that comorbidity increases the complexity of cancer management and affects early mortality. Cancer control and treatment research questions should be pertinent to older-aged persons with this tumor and should factor in their concurrent age-related chronic disease problems.

The long term results of this trial confirm that 5-fluorouracil combined with high dose folinic acid is a well-tolerated, effective 6-month adjuvant regimen for patients with colon carcinoma that has no detrimental effect on their quality of life.

Minute nodular intrahepatic cholangiocarcinoma appears to be related to hepatitis viral infection and could be detected at an early stage by follow-up of patients with chronic hepatitis or cirrhosis.

Primary pancreatic lymphangiomas are rare neoplasms that are usually mistaken radiographically for cystic epithelial tumors of the pancreas. Pancreatic lymphangiomas occur predominantly in females within a wide age range. Immunohistochemical reactions (with CD31 and factor VIII-R antigen) can help distinguish these tumors from epithelial lesions. The prognoses of patients with these tumors are uniformly excellent.

The results of this study indicate that p53 expression, in contrast to bcl-2 and p21 expression, correlates significantly with the clinical outcomes of patients with laryngeal squamous cell carcinoma.

Carboplatin (at a dose based on the area under the plasma concentration versus the time curve, AUC), combined with irinotecan (CPT-11), plus recombinant human granulocyte colony-stimulating factor (rhG-CSF) support, appears to be an active regimen for the treatment of patients with nonsmall cell lung carcinoma. The recommended doses for Phase II studies are 60 mg/m² of CPT-11 and a target AUC of 5 mg·min/mL for carboplatin, plus rhG-CSF.

Bronchial epithelial cells produce a significant amount of granulocyte-macrophage-colony stimulating factor (GM-CSF), which is believed to mediate both the host defense and inflammation. In this study, the biologic role of GM-CSF produced by squamous cell lung carcinoma was examined.

The HM1.24 antigen is a transmembrane glycoprotein selectively expressed on terminally differentiated B cells and serves as a target for detection of human myeloma in vivo.

Paraspinal malignant peripheral nerve sheath tumors (MPNSTs) have more aggressive behavior than MPNSTs of the lower extremities and other sites, mainly due to incomplete resection of the primary lesion. Prognoses of patients with MPNST at this site appear to be affected by resection status, tumor size, and tumor grade.

The addition of tamoxifen to radiotherapy for postmenopausal, axillary lymph node negative breast carcinoma patients treated with breast-conserving surgery resulted in a reduced rate of ipsilateral and contralateral breast tumor recurrences. See also pages 2090-2.

The number of positive surgical margins affects outcome in women undergoing breast conservation therapy. Adequate margin assessment is necessary for tumor control.

Mammographically detected breast carcinoma in patients treated with breast-conserving therapy has similar clinical and pathologic characteristics in women age < 50 years or women age ≥ 50 years, whereas clinically detected breast carcinoma appears to be more aggressive in younger women.

Positron emission tomography with 2-deoxy-2-fluoro[¹⁸F]-D-glucose (FDG) was performed on 70 patients with primary breast carcinoma, and the differential absorption ratio calculated as an index of FDG uptake was found to be useful for predicting the prognoses of these patients.

Using a Markov model, data from recent studies on the benefit of screening mammography were used to reassess the cost-effectiveness of this procedure. The marginal cost per year-life saved was within the acceptable range for all the screening strategies evaluated. These data may be useful in health policy decision-making.

Improved disease free survival is observed after pretreatment surgical staging in patients with cervical carcinoma in whom all lymph node metastases can be debulked.

Measurement of carcinoembryonic antigen and squamous cell carcinoma antigen levels is advisable for patients age 45 years or older who have an ovarian tumor larger than 99 mm in greatest dimension with characteristics of mature cystic teratoma.

Prostate specific membrane antigen (PSM) is a diagnostically useful marker for prostate carcinoma. Expression of PSM is clinically useful for the identification of prostate epithelium, particularly high grade prostate intraepithelial neoplasia or adenocarcinoma, and its expression is regulated independently of prostate specific antigen.

MIB-1 (Ki-67) labeling index is associated with the recurrence free survival of patients with primary meningiomas and is a useful adjunct to routine histology in selected cases. Flow cytometry and p53 immunohistochemistry offer no additional prognostic information.

A Phase II trial of paclitaxel 250 mg/m² (24-hour infusion) resulted in a 40% response rate and 33% 1-year survival rate in 30 eligible patients with recurrent or locally advanced incurable carcinoma of the head and neck.