[Functional activity of the lymph nodes in oncological patients].
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Biomedical subjects
Publications and source records attributed to N N Trapeznikov.
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From September, 1967, to January, 1974, a clinical trial was carried out by the WHO Melanoma Group to evaluate the efficacy of elective lymph-node dissection in the treatment of malignant melanoma of the extremities with clinically uninvolved regional lymph nodes. Treatment was prospectively randomized: 267 patients to excision of primary melanoma and immediate regional-lymph-node dissection and 286 to excision of primary melanoma and regional-lymph-node dissection at the time of appearance of metastases. The statistical analysis showed no difference in survival between the two groups of patients, regardless of how the data were analyzed (according to sex, site of origin, maximum diameter of primary tumor or Clark's level or Breslow's thickness). Elective lymph-node dissection in malignant malanoma of the limbs does not improve the prognosis and is not recommended when patients can be followed at intervals of three months.
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Patients with malignant skin melanoma were given different kinds of immunotherapy; nonspecific immunotherapy with BCG vaccine, adaptive immunotherapy with methotrexate or phytohemagglutinin activated autolymphocytes, and also a combination of polychemotherapy with BCG. The state of cell immunity was determined prior to, during and at the end of the therapy, in accordance with the courses. As a result of the conducted therapy an increased level of cell immunity was observed, that usually corresponded to clinical development of the disease. At the same time, the increase in immune response indices due to continuous administration of BCG vaccine is not related with the clinical course, while the persistent anergy or reduced level of cell immunity during this kind of therapy is a poor prognostic sign.
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Seven incurable patients with disseminated malignant melanoma were injected (subcutaneously, sometimes intravenously) with homogenate of bovine pineal tissue. The daily injections of large quantities of pineal tissue appeared to be harmless for patients. Many-fold injections (during 9.5 months) of large quantities of pineal tissue (up to 3950 g) in 1 of 7 cases produced certain effect on subcutaneous metastases of malignant melanoma, i.e. causing reduction and even disappearance.
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Homovanillic acid (HVA) was determined both in 45 patients with different forms of melanoma and those hospitalized on the suspicion of melanoma and in 15 healthy persons. Excretion rate of homovanillic acid within the normal limits was observed in patients with benign melanotic neoplasms of the skin (4.4 +/- 0.56 mg/24 hr) and in local forms of melanotic melanoma of the skin (4.5 +/- 0.24 mg/24 hr). In patients with metastases to regional nodes as well as in patients with locally disseminated forms of melanotic melanoma of the skin the concentration of homovanillic acid increased up to 11.1 +/- 0.93 mg/24 hr. Especially strong concentration of homovanillic acid was registered in patients with disseminated malanotic melanoma of the skin, and it made up 15.7 +/- 2.04 mg/24 hr. There was evident tendency to the elevation of HVA excretion level as generalization of the process which was taking place. The data obtained enable the authors to recommend the determination of HVA excretion as an additional diagnostic test as well for prognosis of melanoma development together with other clinicomorphological data.
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The main principles and the structure of the cancer control organization in the USSR are described. The trends in the incidence of selected forms of malignant tumors and regional differences in USSR are documented with statistical data.
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