Cancer

A retrospective study of morphologic prognostic features in 96 cases of resected Barrett's-associated adenocarcinoma, either with (61 cases) or without (35 cases) preoperative neoadjuvant chemoradiotherapy, found that older patient age, higher pathologic stage, absence of peritumoral lymphoid infiltrate, and most likely perineural invasion were associated with shortened survival by multivariate analysis. The effect of chemoradiotherapy, as assessed by the degree of residual tumor, did not correlate with survival in this patient group.

Seventy-one gastric carcinoma patients with serosal invasion were treated with intraperitoneal hyperthermic chemoperfusion combined with surgery. The survival rate of these 71 patients was significantly higher than that of the control group of 70 patients who were treated with surgery alone.

A Phase III trial was performed to evaluate the impact of interferon on the efficacy of levofolinic acid and 5-fluorouracil against metastatic colorectal carcinoma, as well as the role of tumor burden and liver involvement as prognostic factors. Interferon did not appear to have a positive influence on patient outcome, although liver involvement and tumor burden were found to be important prognostic factors.

The results of this study indicate that significant activation of CDK2 and cdc2 occurs in primary colorectal carcinoma.

Serum levels of transforming growth factor-β1 (TGF-β1) in patients with colorectal carcinoma were significantly higher than those in normal control subjects and these levels decreased significantly after curative surgical resection. These results suggest that the serum level of TGF-β1 might be a useful biomarker in the management of colorectal carcinoma. See also pages 517–9.

To the authors' knowledge, this series of 137 cases is the largest series reported from one institution. Epithelioid hemangioendothelioma is of unknown etiology and only one histologic parameter, tumor cellularity, is predictive of outcome.

Paraaortic lymph node involvement in invasive ductal carcinoma of the pancreas is common and highly significant for prognosis. Therefore the resected specimen should include the paraaortic lymph nodes.

In this study, the rate of spontaneous apoptosis occurring in laryngeal carcinoma was closely associated with mitotic activity but appeared to be unrelated to protein expression of bcl-2 and bax. Elevated bcl-2 and reduced bax levels were correlated with adverse prognostic parameters.

The authors studied the molecular changes present in 59 cases representing all 4 types of pulmonary neuroendocrine tumors. Their findings support the clinicopathologic concept that neuroendocrine tumors of the lung represent a spectrum ranging from low grade typical carcinoids to highly malignant neuroendocrine carcinomas.

Solitary extramedullary myeloid sarcoma as a pattern of recurrence following allogeneic bone marrow transplantation in patients with acute or chronic myeloid leukemia is rare. The prognosis for this group of patients is very poor, as in any case of posttransplantation leukemic relapse, with the exception of patients with chronic myeloid leukemia.

Patient tumor and treatment factors as potential predictors for local recurrence after surgery for ductal carcinoma in situ are reviewed. This meta-analysis shows that various pathologic factors and conservative surgery alone are predictors for higher incidence of local recurrence.

This single-institution review of 229 male breast carcinoma patients who presented during the years 1955–1996 describes clinical presentation, some changes in treatment practices, and no improvement in outcome over the 4-decade period. Collection of detailed, prospective data on male breast carcinoma patients may optimize clinical management.

Breast carcinoma patients treated with adjuvant cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) chemotherapy have a significantly higher risk of late cognitive impairment than breast carcinoma patients not treated with chemotherapy. This cognitive impairment is unaffected by anxiety, depression, fatigue, and time since treatment, and is not related to patients' reports of cognitive dysfunction.

In vivo vascularity index was found to correlate well with in vitro microvessel density. The authors believe the in vivo vascularity index would help to predict lymph node metastasis in patients with cervical carcinoma.

Enhanced expression of transforming growth factor-β (TGF-β)1 and TGF-β3 mRNA, as well as loss of expression of TGF-β receptors TβR-I and TβR-III, were observed in ovarian carcinoma specimens, suggesting a role for alterations in TGF-β-mediated pathways in ovarian tumorigenesis.

Clear cell carcinoma exhibits higher expression of cyclin E and p21 and lower expression of p53 and cyclin A than any other histologic subtype of ovarian adenocarcinoma.

Changes in complications between 4 and 8 years after radiotherapy were prospectively assessed among prostate carcinoma patients who received a self-assessment questionnaire, and these changes were compared with those found in an age-matched population.

The tumor size cutoff of 5.5 cm, rather than 7.0 cm, in the TNM system (fifth edition, 1997) for classifying renal cell carcinoma was most significantly predictive of the survival of Robson Stage I patients after radical nephrectomy. The tumor size cutoff of 5.5 cm was also shown to be significant in univariate and multivariate analyses.

Breast carcinoma developing after thyroid carcinoma was diagnosed more frequently than expected in young adult women. This potential association and plausible mechanisms should be evaluated in larger cohorts of patients.

The authors report on the responses to therapy and clinical outcomes of patients with the clinical and histopathologic features of unicentric and multicentric Castleman's disease treated at a single institution. The current understanding of the pathogenesis of this disease in regard to possible treatment strategies is discussed.

Point mutations and rearrangements of the p53 gene were found in 9 (10.8%) of 84 non-Hodgkin's lymphomas. Patients who carried these alterations had worse outcomes than other patients. Of three patients with gene rearrangements, the two with one abnormal p53 allele had a more favorable prognosis than the one with two abnormal alleles.