Samuel S. Kurohara

Metastasis to organs in carcinoma of the uterine cervix: Influence of treatment on incidence and distribution

Two hundred seventy‐eight autopsied cases of various stages of cervical cancer treated at Roswell Park Memorial Institute, Buffalo, New York, were evaluated to determine the effect of treatment on the spread of the disease. Patients were categorized, according to the primary treatment, into four groups: radiation, 183 cases; surgery, 44 cases; combined radiation and surgery, 34 cases; and other methods, 17 cases. The main clinical parameters of prognostic value were equally present except for earlier clinical stages in the “surgery” and “combined” groups. Clinically, the patterns of recurrence varied with the treatment: increased central pelvic recurrences after surgery, lateral deep pelvic recurrences after combined treatment and distant metastases after radiation. The mean survival in all cases was higher than previously reported, and still higher after radiation. Renal failure and sepsis were the leading causes of death. In the autopsy findings patients having radiation showed an increased risk of extrapelvic metastases whereas the surgical group revealed an increased risk of general pelvic and extrapelvic metastases. This may be explained by the longer survival in both groups, with more frequent local control after radiation. Distant metastases were widespread and the distribution was unaffected by the kind of treatment given for the primary disease.

Treatment of cancer of the paranasal sinuses

Three hundred forty‐four cases of cancer of the paranasal sinuses were treated by radiation (132 cases), surgery (35 cases), and combined surgery and radiation (177 cases). The maxillary sinus was the site of origin in 88% of the cases, and the ethmoids in 9%. Squamous cell carcinoma accounted for 80% of the lesions. The 5‐year cure rate in the entire series was 14%. The degree of extension and histology of tumors and the type of treatment influenced the prognosis. Early antral lesions showed 18–35% 5‐year cure Adenocarcinoma had the best prognosis, followed by well‐differentiated squamous cell carcinoma. A combined approach of surgery and radiation produced the best results with more adequate control of the primary than either modality alone.

Second primary cancers of endometrial carcinoma

Of 984 patients with corpus cancer treated at Roswell Park Memorial Institute (between 1940 and 1960), 116 (11.8%) were found to have second primaries; of these, 47 had breast cancer, 15 skin cancer, 27 other pelvic cancers, 15 abdominal cancer, 3 head and neck cancer, and 3 lymphoma or leukemia the incidence of second cancers increased with time and age, especially in the sixth and seventh decades the risk of developing mammary cancer was found to be high within 5 years before the development of the uterine cancer. This time relationship is very interesting in that it supports the presumed association between corpus and breast cancer the results of the present study also suggest that there is a subgroup of women who have abnormal estrogen stimulation of both the corpus and the breasts, leading to the development of both corpus and breast cancer.