Carcinoma-related Death Research Articles

The outcome of patients with thyroid carcinoma and graves' disease

A total 847 consecutive patients with Graves' disease who underwent thyroidectomy between 1965 and 1990 were found to have a 4.3% incidence of coincident carcinoma of the thyroid. In 68.2% of these cases the tumors were less than 1 cm in diameter and were detected in only 7 patients (19.4%) prior to surgery. Dissection of the regional lymph nodes was necessary in only 11 patients. A review of the patients in 1990 revealed no carcinoma-related deaths with metastases occurring most commonly in the patients with larger tumors and in those whose cancer had been detected prior to thyroidectomy. Although the detection of potential tumors occurring with Graves' disease using preoperative echogram may be of interest, our results suggest that occult microcarcinoma occurring coincidentally with Graves' disease is not clinically significant as it did not cause any recurrence in this study. Moreover, there was no evidence to suggest that Graves' disease was associated with the increased or rapid growth of these tumors.

Tumor size of renal cell carcinoma: its clinical implication.

We studied the clinical implication of tumor size in renal cell carcinoma, by revealing its relation with the other histopathological and clinical features. The tumor size was well correlated with histopathological findings and metastatic status of the carcinoma. Smaller carcinomas (usually less than 60 mm) generally had a higher disease-specific survival than those of 60 mm or greater. The results indicated that the size reflected the biological character of the carcinoma. However, 10% of patients with the smaller carcinoma had lymph node metastasis or distant metastasis at the time of diagnosis, each of which contributed to a renal cell carcinoma-related death in the early follow-up period.

Long-term survival in small cell carcinoma of the lung

A series of 1019 patients with small cell carcinoma of the lung, treated at the Department of Radiotherapy and Oncology at the Helsinki University Central Hospital during the period 1963–1982, included 19 patients who survived for 5 years or more after the diagnosis. The clinical data of these patients were retrospectively studied in order to elucidate factors which may have contributed to the more favourable outcome. All of the 5-year survivors were previously untreated, and all had a good performance status at the time of diagnosis. In 95%, the disease was limited to one hemithorax, and 74% had a stage I or II tumour. All treatment modalities, except immunotherapy, were used during the two decades. Surgery alone, or with adjuvant radiotherapy, and/or chemotherapy, was the primary treatment in eight of the long-term survivors ( 42%). Chemotherapy, either alone or in combination with radiotherapy, was the primary treatment in 10 19 ( 53%) patients and radiotherapy alone was given to one of the 5-year survivors. The objective response rate to the primary treatment was 100% and complete response was achieved in 95%. There were seven carcinoma related deaths after 5-year disease-free survival. The first site of relapse was the central nervous system in three cases and the liver in three cases. Acute myocardial infarction was the cause of death in five patients. One patient died of the other carcinoma and six are still alive with no evidence of SCCL. In conclusion, a good performance status at diagnosis, no pretreatment weight loss, the extent of disease and good response to the primary treatment appeared to be prognostically important in the present study. Some patients with very limited disease may benefit from primary treatment comprising surgery and adjuvant chemotherapy.