Sixty-five patients with Stage I and II endometrial carcinoma were investigated. After a short-time follow-up (17-24 months) significant differences in frequency of relapses were observed between patients with tumors containing low amounts of estrogen receptor (ER less than 60 fmol/mg DNA) in the nuclear pellet, and those with tumors containing greater than 60 fmol ER/mg DNA (p = 0.01). Other prognostic factors showed no differences in frequency of relapses. In this small patient material with a short-time follow-up we therefore suggest that ER in the nuclear pellet may be an important prognostic factor.

Six hundred and forty-four patients with primary malignant tumours of the female genital tract were subject to a two-stage screening program on admission, with clinical examination in all and mammography in 380. Clinical examination alone revealed 4 cancers, while supplementary mammography screening of 369 patients with normal clinical examination revealed an additional 6 tumours, of which 5 were invasive. The prevalence rate was about three times that found in two mass-screening programs in different parts of Sweden. Thus, it could be concluded that there is an increased risk for mammary carcinoma in patients with gynaecologic malignancies. It seems reasonable therefore, to recommend mammography routinely in this group of patients.

The correlation between certain prognostic factors and the 10-year survival/lethality rate was analysed in 168 patients with invasive squamous cell carcinoma of the uterine cervix stage I A-II B treated by radiation therapy from 1969 through 1970. These factors included a malignancy grading system (MGS) consisting of 8 items: structure (P1), differentiation into cell type (P2), nuclear polymorphism (P3), mitosis (P4), mode of invasion (P5), stage of invasion (P6), vascular invasion (P7), and host-cellular response (P8). Histologic differentiation (1) and differentiation into cell type (11), the patient's age, the year of admission, the clinical stage (FIGO), and irradiation were also analysed. Many of these factors were correlated to the prognosis. However, the MGS system was superior as a predictive factor. Patients with a low MGS score had an extremely good survival rate at both the 5- and 10-year controls. The patients with a high MGS score had approximately 55 per cent lethality at 10 years. The MGS was significantly superior to each separate item as well as to each predictive factor (p less than 0.05). Further, no other important predictive factor could be identified after the MGS had been included in the multivariate analyses.

In a material of 21 patients including 7 primary and 6 recurrent vulvar carcinomas, 5 vaginal carcinomas, 1 urethral carcinoma and 2 preinvasive vulvar carcinomas operation was performed with a CO2-laser scalpel. In 9 radical and 3 partial vulvectomies no primary closing of the wounds was performed. In the remaining primary closing was performed. The operative bleeding and healing process with laser scalpel and electrosurgical scalpel using open wound technique were about the same. The surgical time was longer with the laser technique but the operative specimens were better preserved. Healing of the primary closed wounds were uncomplicated.

A clinical and histopathologic study of material from a series of 21 patients with basal cell carcinoma treated from 1960 until 1979 are reviewed. In 3 patients 'mixed' tumor was recorded. The histopathologic diagnosis: basosquamous carcinoma and the behavior of this carcinoma are discussed. The mean age of the patients was 76 years. Presenting symptomatology consisted primarily of bleeding, burning or itching, and ulcerations. No case of pure basal cell carcinoma gave metastasis to the regional lymph nodes, in no case could the cause of death be attributed directly to this kind of lesion. A conservative approach consisting of wide local excision is suggested.

A series of 244 patients with vulvar squamous cell carcinomas was analyzed with regard to treatment of the regional lymph nodes. In 144 patients, groin dissection was performed, supplemented in 24 cases by pelvic lymphadenectomy. Preoperative irradiation was given and in cases with positive nodes postoperative irradiation as well. Patients in whom lymph node dissection was not performed received irradiation. Treatment failures in the regional lymph node regions were analyzed and the policy concerning treatment of the regional lymph nodes is discussed.

Eighty-six patients with invasive squamous cell carcinoma of the vulva stage I were followed for 2 to 20 years after surgical treatment varying from local excision to radical vulvectomy with inguinal lymph node dissection. The results are presented and the prognosis discussed in relation to the radicality of the surgical intervention, the degree of tumour differentiation, the morphologic properties of tumour cell population, and the tumour host relationship. The most important prognostic factor seemed to be the radicality of the surgical intervention. To reduce patient morbidity in radical surgery while still achieving a comparable survival rate an operative approach with less than radical vulvectomy, inguinal dissections or pelvic lymphadenectomy, or both, is proposed for selected patients.

Radical vulvectomy using warm-knife and open-wound techniques was performed as the first step in a two-phase surgical approach in 274 patients with malignant vulvar tumors. Crude 5-year survival was registered in 133223 (60%) patients. The complication rate was low and the hospitalization period was short (mean 16 days).

Nineteen patients with recurrent endometrial carcinoma and one patient with Stage IV endometrial carcinoma not previously treated with chemotherapy were treated with a combination of doxorubicin and cisplatin. The dose schedule was doxorubicin, 50 mg/m2 on day 1, and cisplatin, 50 mg/m2 with hyperhydration on day 1, with a new course every 4 weeks. Objective response 60% was obtained in 12 out of 20 patients (two with complete remission and 10 with partial remission). Furthermore, four patients had stationary disease. The two patients with complete remission both had distal vaginal metastases, and they are still alive after >21 and >40 months. The median survival period for those with partial remission was >11 months (range of 4 to 26); for those with stationary disease, 7 months (range of 4 to 10), and for those with progressive disease, 4 months (range of 3 to 7). The response rate was higher for well-differentiated tumors. No serious side effects were noticed. To our knowledge no other reports have been published so far with the use of the same regimen in patients with recurrent endometrial adenocarcinoma with no prior chemotherapy. We find the objective response rate, the survival time, and the quality of life for the responding patients in our study so encouraging that we shall continue with a larger trial.

Abstract. In the present phase II trial, 26 heavily pretreated patients with advanced recurrent ovarian carcinoma were treated with tranexamic acid, 4 − 6 g per os daily for at least 3 months. Of these 26 patients, 3 had stage IIb, 21 stage III and 2 stage IV. Histologic examination revealed serous adenocarcinoma in 13, mucinous in 3, endometroid in 4, 1 anaplastic and 5 unspecified adenocancer. Twenty of the tumors were poorly differentiated and 5 highly‐moderately differentiated. No objective response was noted but all the highly‐moderately differentiated tumors showed a stable disease state with a median duration of 6 months (range 4 — 36 months). The patients with poorly differentiated tumors had a median survival of 4 months. Most of the patients had some form of gastro‐intestinal side effect. This investigation has shown that treatment with tranexamic acid was not particularly helpful in poorly differentiated cases in which modern combined chemotherapy already had failed. The effect in highly‐moderately differentiated cases needs further evaluation.

A total of 555 cases of malignant epithelial ovarian tumour diagnosed in vivo was reported to the Regional Tumour Registry for Southern Sweden, Lund during 1974-1978. Of these 428 (77%) were referred to the Department of Oncology, Lund, which serves the Southern Swedish Health Care Region. Patients not being referred were mostly elderly with advanced tumours. The selection of patients will thus affect the evaluation of the treatment results. The standard surgical procedure was bilateral salpingo-oophorectomy with or without hysterectomy, and infracolic omentectomy. 95% of the patients were treated according to a randomized trial including postoperative chemotherapy, radiotherapy or a combination of both. Preoperative radiotherapy in primarily inoperable patients increased the operability. 34% of all stage IIb, IIc, III, and IV-patients were thus operated or reoperated with only small residual tumour or none at all following surgery. Stage, grade and size of postoperative residual tumour were the most important prognostic factors. The five-year cumulative survival rate for all patients referred to the Department of Oncology was 32%.

Thirty-three patients with advanced cervical cancer (31 squamous cancer, two adenosquamous cancer) previously untreated with cytotoxic drugs, were treated with bleomycin, 5 mg daily, for seven days and mitomycin C, 10 mg, on day 8. This regimen was repeated four times at two-week intervals. All but one patient had previously been treated with radiotherapy; 36% of the patients had an objective response (five complete remission (CR), median duration 12 months; seven partial remission (PR), median duration six months). Severe myelosuppression occurred in nine patients. One drug-related death due to thrombocytopenia occurred. Three patients developed pulmonary fibrosis and one of them died of respiratory failure. The bleomycin-mitomycin C regimen has a definite but clearly limited effect in advanced cancer of the uterine cervix.

Two materials consisting of patients with early invasive squamous cell carcinoma of the uterine cervix have been studied in regard to the influence of age and treatment technique on prognosis. In the first material, consisting of 254 Stage Ib patients treated only with radiation therapy, a poorer prognosis was found in the women under 35 years of age. The second material consisted of 274 Stage Ib patients who had been preoperatively irradiated and had undergone radical hysterectomy. The prognosis was (not significantly) better for those patients under 35 years of age in this group. The rate of central recurrence was higher among the younger patients who received only radiation therapy. Analysis of histologic grading and cell type according to J. W. Reagan and S. F. Yao (Int. J. Radiat. Oncol. Biol. Phys.5, 1015–1020 (1979)) revealed no explanation for the poorer prognosis among younger women treated solely with radiation therapy.

A prospective randomized trial for comparing the effects of chemotherapy and radiotherapy on survival in malignant epithelial ovarian tumours was carried out during the years 1975-1978 in 142 (90%) of a total material of 157 patients in Stage I and Stage II of this disease. Stratification was done according to the state of the tumour capsule and the type of histology found in Stages Ia and Ib. Two types of randomized treatment were given: A. Patients with no extracystic excrescences and intact tumour capsule with mucinous tumours in Stages Ia and Ib were given Melphalan or were not treated, while those with non mucinous tumours were given Melphalan or radiotherapy; B. All of the other patients with tumours in Stage I and Stage II were treated with radiotherapy alone, or were irradiated in combination with Melphalan treatment. Both of these treatment groups had about the same rates of 2- and 5-year survival. It was seen that the histological grade and the amount of residual tumour left at surgery are important prognostic factors. Postoperative treatment does not seem to improve cases of well differentiated, early mucinous tumours in Stage Ia. Acceptable results were obtained, however, irrespective of histological type, in early Stage I, moderately differentiated tumours treated with Melphalan or radiation therapy, and in well- or moderately differentiated tumours in Stage I or Stage IIa using irradiation alone or in combination with chemotherapy. Stages IIb and IIc, and all poorly differentiated tumours in Stages I and II, require more aggressive treatment.

Acta Obstetricia et Gynecologica ScandinavicaVolume 61, Issue 1 p. 93-95 Giant Condyloma Acuminatum with Focal Malignant Degeneration Claes Tropé, Corresponding Author Claes Tropé Gynecologic Section, Department of Oncology, University Hospital, Lund, Sweden Department of Pathology, University Hospital, Lund, Sweden Department of Obstetrics and Gynecology, University Hospital, Lund, SwedenGynecological section Department of Oncology University Hospital S − 221 85 Lund SwedenSearch for more papers by this authorHans Grundsell, Hans Grundsell Gynecologic Section, Department of Oncology, University Hospital, Lund, Sweden Department of Pathology, University Hospital, Lund, Sweden Department of Obstetrics and Gynecology, University Hospital, Lund, SwedenSearch for more papers by this authorHans Henrikson, Hans Henrikson Gynecologic Section, Department of Oncology, University Hospital, Lund, Sweden Department of Pathology, University Hospital, Lund, Sweden Department of Obstetrics and Gynecology, University Hospital, Lund, SwedenSearch for more papers by this authorJohn-Erik Johnsson, John-Erik Johnsson Gynecologic Section, Department of Oncology, University Hospital, Lund, Sweden Department of Pathology, University Hospital, Lund, Sweden Department of Obstetrics and Gynecology, University Hospital, Lund, SwedenSearch for more papers by this authorBengt Lindahl, Bengt Lindahl Gynecologic Section, Department of Oncology, University Hospital, Lund, Sweden Department of Pathology, University Hospital, Lund, Sweden Department of Obstetrics and Gynecology, University Hospital, Lund, SwedenSearch for more papers by this authorErnst Simonsson, Ernst Simonsson Gynecologic Section, Department of Oncology, University Hospital, Lund, Sweden Department of Pathology, University Hospital, Lund, Sweden Department of Obstetrics and Gynecology, University Hospital, Lund, SwedenSearch for more papers by this author Claes Tropé, Corresponding Author Claes Tropé Gynecologic Section, Department of Oncology, University Hospital, Lund, Sweden Department of Pathology, University Hospital, Lund, Sweden Department of Obstetrics and Gynecology, University Hospital, Lund, SwedenGynecological section Department of Oncology University Hospital S − 221 85 Lund SwedenSearch for more papers by this authorHans Grundsell, Hans Grundsell Gynecologic Section, Department of Oncology, University Hospital, Lund, Sweden Department of Pathology, University Hospital, Lund, Sweden Department of Obstetrics and Gynecology, University Hospital, Lund, SwedenSearch for more papers by this authorHans Henrikson, Hans Henrikson Gynecologic Section, Department of Oncology, University Hospital, Lund, Sweden Department of Pathology, University Hospital, Lund, Sweden Department of Obstetrics and Gynecology, University Hospital, Lund, SwedenSearch for more papers by this authorJohn-Erik Johnsson, John-Erik Johnsson Gynecologic Section, Department of Oncology, University Hospital, Lund, Sweden Department of Pathology, University Hospital, Lund, Sweden Department of Obstetrics and Gynecology, University Hospital, Lund, SwedenSearch for more papers by this authorBengt Lindahl, Bengt Lindahl Gynecologic Section, Department of Oncology, University Hospital, Lund, Sweden Department of Pathology, University Hospital, Lund, Sweden Department of Obstetrics and Gynecology, University Hospital, Lund, SwedenSearch for more papers by this authorErnst Simonsson, Ernst Simonsson Gynecologic Section, Department of Oncology, University Hospital, Lund, Sweden Department of Pathology, University Hospital, Lund, Sweden Department of Obstetrics and Gynecology, University Hospital, Lund, SwedenSearch for more papers by this author First published: January 1982 https://doi.org/10.3109/00016348209156960Citations: 8AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. 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Citing Literature Volume61, Issue1January 1982Pages 93-95 ReferencesRelatedInformation