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PubMed1995

The Gracz arteriovenous fistula evaluated. Results of the brachiocephalic elbow fistula in haemodialysis angio-access.

OBJECTIVES: To assess fistula patency and complication rates in braciocephalic elbow fistulas of both the Gracz and the side-to-side configuration. DESIGN: Retrospective clinical study. METHODS: Life table patency and complications of 50 Gracz fistulas and 23 side-to-side elbow fistulas created between 1988 and 1993 were reviewed. RESULTS: The cumulative patency for the elbow fistulas was 84% after 1 year and 78% after 3 years. No difference was found between the Gracz fistula and the side-to-side elbow fistula. Stenosis was the most frequent indication for revision and thrombosis was the most frequent cause of fistula failure. CONCLUSION: The elbow fistula has a long patency with few complications and performs as well as wrist fistulas and better than the graft fistulas reported in the literature. The Gracz elbow fistula has results as good as the side-to-side elbow fistula. Graft fistulas should be reserved for tertiary procedures only.

Adolescent↗

PubMed1998

The influence of the state of the vertebral arteries on the peri- and postoperative risk in carotid surgery.

OBJECTIVES: To assess the significance of the vertebral arteries (VA) as a prognostic factor within the framework of carotid surgery. DESIGN: Prospective observational study. MATERIALS: A total of 1338 operations were performed on 1182 patients. Three hundred and six of the patients had angiographically confirmed unilateral (299) or bilateral (seven) involvement of the VA. In 31 cases it was not possible to assess the VA. METHODS: Life table analysis. RESULTS: Thirty-day mortality rate was 1.6% (21 out of 1338) for all reconstructions of the internal carotid artery. In addition to three fatal strokes, 22 hemispheric events were noted (1.6%, 22/1338). Follow-up varied between 1 and 96 months (mean 34, S.E.M. 0.76, median 29) and covered a total of 3361 patient years. The cumulative 5-year survival rate was 69%. Irrespective of age, cardiac events were the leading cause of death. In patients with VA involvement, both the 30-day stroke and mortality rate (p < 0.01) and the long-term survival rate (p < 0.01) were significantly poorer. CONCLUSION: Concomitant vertebral artery disease increases the morbidity and mortality of carotid surgery, presumably due to reduced collateral perfusion during cross-clamping. However, the overall risk of surgery remains acceptable.

Aged↗

PubMed1980

The lifetime prevalence of mental disorders: estimation, uses and limitations.

The age-specific lifetime prevalence rate of a disease is the proportion of persons surviving to a given age who have experienced the disease at any time during their lives. This measure of morbidity has been used to report findings in many of the epidemiological surveys of mental disorders of the last 30 years. This paper presents a life-table method for estimating age-specific lifetime prevalence rates from incidence and mortality data. The method is applied to Monroe County, New York, case register data on the incidence of schizophrenia. Using this method, we estimate that at least 3% of the White population surviving to age 55 have experienced an episode of schizophrenia at some time during their lives. The difficulties of producing valid estimates of lifetime prevalence and the difficulties in interpreting differences reported in such rates make this morbidity measure of secondary importance to incidence and point-prevalence data.

Actuarial Analysis↗

PubMed1999

Factors associated with discontinuation rates of the copper T380A IUD in a Peruvian public hospital.

The objectives of this study were to evaluate performance and causes of discontinuation of the Copper T380A IUD by users at the Family Planning Service at Hospital Arzobispo Loayza in Lima, Peru, during a period of three years. The study included 3167 acceptors of the CuT380A attending the service during 1992-1994. IUDs were inserted during interval timing. Follow-up was at 1, 12, 24 and 36 months after insertion. The following events were recorded: number of pregnancies, expulsions and all causes of discontinuation. The cumulative rates per 100 woman-years using the life-table method was calculated. Also calculated were the relative risks for expulsion and for pregnancy. At the end of the study, 361 women had discontinued the method for various reasons, whereas 1667 women continued using the method. The lost-to-follow-up proportion increased over time from 35.9 per 100 woman-years for the first year to 38.2 for the third year. The cumulative discontinuation rate over three years was 22.6 +/- 1.3 (cumulative rate +/- standard error) per 100 woman-years. The cumulative pregnancy rate for three years was 1.2 +/- 0.4 per 100 woman-years, whereas the cumulative rate of expulsion was 4.9 +/- 0.4 for the first, 6.4 for the second and 6.8 for the third year. The main cause of discontinuation during the first year of use was expulsion (4.9 per 100 woman-years) followed by personal reasons (2.1 per 100 woman-years). At the end of the third year, the main cause was personal reasons (11.4) and the second cause was expulsion (6.8). A higher probability of expulsion, pregnancy and discontinuation for bleeding and/or pain was associated with age less than 20 years. In conclusion, the effectiveness of the CuT380A IUD after three years of use was 98.8 per 100 woman-years, whereas continuation was 39.2, and loss to follow-up increased over time.

Female↗

PubMed2000

Childhood cancer survival in Cuba.

Reports dealing with childhood cancer population-based survival have not yet been published in Cuba. A survival study including cases reported to the National Cancer Registry in the period 1988-1989 have been accomplished in the National Cancer Registry of Cuba. A comprehensive view of its results in childhood cancer is intended to be shown in this paper. All sites childhood cancer cases aged below 15 years (400) and reported in this period were included derived from a total of 578 incident cases. Vital status of cases was checked-up to December of 1994 by a mixed follow-up. Survival analysis was achieved by the life-table method using the SPSS for Windows software. Relative survival rates were not included because no differences were appreciated with the observed ones. Cases between 0-4 years and females account for the highest frequencies. Leukaemia accounts for 27% of the cases, followed by lymphomas and tumours of the central nervous system. Lymphoid and non-lymphoid acute leukaemia had 41 and 9% 5-year survival rate respectively being the latter comparable with Bangalore, India (10%). For lymphomas, Hodgkin's disease present better prognosis compared with non-Hodgkin lymphoma with 73 and 35% 5-year survival rates, respectively. Figures are comparable to the corresponding to Bangalore, India (72 and 33%, respectively). For time trends survival distribution were compared by period of diagnosis (1982/1988-1989). In all cases differences resulted statistically non-significant with lower rates for 1988-1989 except for lymphomas. International reports show increasing time trends for childhood cancer. Nevertheless, these results may serve as a milestone for future comparisons, corresponding with the creation of the National Program for Childhood Cancer Control and future studies will confirm the success of its measures.

Adolescent↗

PubMed1983

Malignant ovarian tumours in childhood in Britain, 1962-78.

The files of the Childhood Cancer Research Group and of the Oxford Survey of Childhood Cancers were scrutinized for all the ovarian neoplasms registered in England, Scotland and Wales in children under age 15 years throughout the period 1962-78. Among 172 cases confirmed as malignant ovarian tumours, 145 (84%) were tumours of germ cell origin (54 dysgerminomas, 36 malignant teratomas, 26 endodermal sinus tumours, 4 embryonal carcinomas, 2 pure choriocarcinomas, 20 mixed germ cell neoplasms, 3 gonadoblastomas), 13 (8%) were epithelial carcinomas (3 serous or undifferentiated, 10 mucinous), 9 (5%) were sex-cord stromal tumours (3 granulosa cell, 3 Sertoli-Leydig, 3 unclassified) and 5 (3%) were other miscellaneous tumour types. Less than 10% of the neoplasms occurred at age less than 5 years, approximately 20% from 5-9, and greater than 70% from 10-14 years. Germ cell neoplasms of greater malignancy (immature teratomas, endodermal sinus tumours) occurred in a significantly higher proportion at younger age (less than 10 years) than dysgerminomas (P = 0.01). The overall incidence (approximately 1.7 cases per 10(6) per annum) did not show any noticeable trend over the 17-year period considered. The clustering of two confined cases and, possibly, a third case, of germ cell neoplasms in three generations of the same family pointed to a genetic component in the aetiology of some of these neoplasms. A large number of sex related and mental or neurological abnormalities was also reported in case children. The 10-year survival rates, determined by the life-table method were: epithelial carcinomas 73%, sex-cord stromal tumours 44%, dysgerminomas 73%, malignant teratomas 33%, endodermal sinus tumours 39%, embryonal carcinomas 25%, other germ cell neoplasms 30% and gonadoblastomas 100%. Apart from cell-type, factors associated with prognosis were clinical stage (in all types), size and degree of histological differentiation (in malignant teratomas, but only when stage was not allowed for). The adoption of efficacious polychemotherapy regimens completely changed the prognosis of germ cell tumours other than dysgerminomas (from 29% to greater than 85% disease-free survivors in the present series).

Adolescent↗

PubMed1983

Cutaneous malignant melanoma in West Yorkshire: I. A prospective study of variables, survival and prognosis.

A prospective study was made of 150 cases of primary invasive cutaneous malignant melanoma in clinical stage I diagnosed during the period 1966-1980. Thirty-six of the patients were male, the remaining 114 female, and thus the age-standardized male:female ratio was 2.9:1. One hundred and forty cases were part of the first author's personal series while the data for the remaining 10 patients were provided by colleagues and were subject to the same prospective approach. As a preliminary to multivariate analysis 19 clinical and pathological variables were subject to contingency table analysis to determine significant associations between pairs of variables. Sixty-six nominally significant associations were found of which 28 were highly significant (P less than or equal to 0.0001). Survival to 3, 5, and 7 years was examined by the life table method and a better survival was found in females than in males. Linear logistic regression analyses with dependent variables of 3, 5, and 7 years were carried out by 2 modifications of Cox's regression model, that with survival to 5 years as the dependent variable showing the best goodness of fit. In this study "level of microinvasion" and "patient's sex" emerged as the primary dominant variables in the 5-year regression model. Possible reasons for this and other apparent anomalies between different Cox's models are discussed.

Adolescent↗

PubMed1987

Tumour aneuploidy, prognostic parameters and survival in primary breast cancer.

Cellular DNA content of primary tumours from 280 patients with operable breast cancer was determined by flow cytometry using nuclei from paraffin sections stained with DAPI, and 199 of these patients were followed for 8-13 years after surgery. Tumours from 67 patients have also been analyzed for their DNA content using single cell suspensions from fresh tumour tissue stained with mithramycin and ethidium bromide, and the results compared with those obtained from paraffin blocks of the same tumours. Overall 60% of the tumours contained cells with abnormal DNA content (DNA-aneuploid populations). Survival and disease free interval were not significantly different in patients with DNA-diploid and DNA-aneuploid tumours when analysed by Mantel's life table method. There was however, an early advantage for patients with DNA-diploid tumours: during the first 30 months after surgery DNA-aneuploidy was associated with higher rate of recurrence and shorter survival. DNA-aneuploidy was strongly related to histological grade. Thus 11/49 (22%) grade I, 60/102 (59%) grade II, and 96/129 (74%) grade III tumours were DNA-aneuploid. Although there was no significant difference in survival of patients with DNA-diploid and DNA-aneuploid tumours overall, there appears to be an unexpected association between DNA-aneuploidy and better survival in grade II patients (P less than 0.01); a similar trend was observed for grade I patients. Although the proportion of DNA-aneuploid tumours was similar in oestrogen receptor positive and negative tumours, DNA-aneuploidy was associated with lower levels of oestrogen receptors in comparison to DNA-diploid tumours. Comparison between the modal DNA values of fresh and paraffin embedded samples showed high rate of comparability (64/67, P less than 0.0001).

Aneuploidy↗

PubMed2004

Self-expanding nitinol stents in the femoropopliteal segment: technique and mid-term results.

The purpose of this study was to evaluate the safety and efficacy of self-expanding SMART nitinol stents in patients with chronic limb ischemia (CLI) demonstrating Type B or C TransAtlantic Inter-Society Consensus (TASC) lesions in the femoropopliteal (FP) arterial segment. There were 137 lower limbs in 122 patients with chronic limb ischemia, secondary to TASC A (n = 12) or TASC B,C (n = 125) lesions in the FP artery were treated with Cordis SMART self-expanding nitinol stents. Hemodynamic stent failure occurred with the presence of a greater than 50% stenosis within the stented segment, measured by standard Duplex velocity criteria, obtained at various postintervention intervals. The hemodynamic primary stent patency was calculated by life-table methods from the time of intervention, uninterrupted by hemodynamic stent failure. The mean lesion length was 12.2 cm (range, 4 to 28 cm). The technical success was 98%. Within the follow-up period (mean, 302 days), 24 limbs were diagnosed with hemodynamic stent failure. The hemodynamic primary stent patency rates were 92%, 76%, 66%, and 60% at 6, 12, 18, and 24-months, respectively. These data provide objective evidence that endovascular treatment of FP TASC A, B and C lesions using self-expanding nitinol SMART stents in patients with chronic limb ischemia provides favorable safety and durability outcomes. Further investigation is warranted.

Aged↗

PubMed1977

[Combination chemotherapy and cranial irradiation in 530 children with acute lymphoblastic leukaemia (author's transl)].

530 children with acute lymphoblastic leukaemia were diagnosed between 1. 1. 1971 and 31. 12. 1974, and treated at 35 German hospitals according to the Memphis study VII or VIII2 and subsequently followed until 31. 12. 1976. At diagnosis 17.2% of the patients had a WBC count of over 50,000/mm3, 8.9% had mediastinal enlargement, 2.1% CNS leukaemia and 1.7% Down's syndrome. After being treated for two and a half years and being observed for a maximum of six years (minimum two years) 262 children (49.4%) were living, 203 (38.8%) in continued complete remission, most of them one to three years after end of treatment. Primary bone marrow relapse occurred in 39.6%, but CNS relapse in only 8.7%. Cranial irradiation at a dose of 1800 rad in 70 patients produced a CNS relapse of only 7.1%. Forty-one of these 530 children (7.7%) died in continued complete remission, the main causes being interstitial pneumonia and varicella. There was no difference in initial features and treatment results between six centres which had many and 29 with rather fewer patients. The five-years-survival rate (life-table method) was 41 +/- 3.5% for all 530 children and 10 +/- 3.7% for the 92 children with initial leucocyte counts of over 50.000/mm3.

Chickenpox↗

PubMed1999

The Giessen-Bad Oeynhausen family study: improved prediction of type I diabetes in a low incidence population of relatives using combinations of islet autoantibodies in a dual step model.

To determine the value of a combined antibody screening for prediction of type I diabetes in a low incidence cohort, we prospectively studied 882 first-degree relatives (485 parents, 382 siblings and 15 offsprings) for up to 11 years who were not preselected for islet cell antibody (ICA) status. During the observation period, 16 individuals developed diabetes. The first serum sample obtained at study entry was analyzed for ICA and antibodies to insulin (IAA), glutamic acid decarboxylase (GADA) and anti-IA-2ic. A multivariate analysis, according to the Cox proportional hazard model considering the joint effects of all baseline variables, selected the four antibodies and the specific family history as significant risk confounding factors (p < 0.05). Further analysis by Kaplan-Meier Life-table methods confirmed a significantly increasing risk of diabetes with the number of autoantibodies present (p < 0.001). In accordance with the Cox model, relatives with more than one affected family member (a multiplex pedigree) and siblings and offsprings vs. parents were at increased risk of IDDM (p < 0.05). In addition to technical problems, a screening strategy based on initial ICA testing has the potential of missing ICA negative subjects among future cases of type I diabetes (19% were ICA negative in the present study) and we therefore set out to evaluate an alternative approach using a dual step strategy with a combination of GADA and anti-IA-2ic for initial screening followed by retesting of positive individuals for ICA and IAA. The combination of GADA and anti-IA-2ic for primary screening (step 1) proved to be more sensitive, identifying 94% of future cases of type I diabetes compared to 81% using ICA as initial test and this antibody combination identified 93% of those individuals with ICA of 20 JDF or more. Retesting of positive individuals for ICA and IAA (step 2) significantly improved the positive predictive value confering a risk of diabetes for siblings and offsprings with more than 2 antibodies within 5 years of 67% (95%CI: 39-90). We conclude that the prognosis of contracting IDDM in relatives is strongly related to the number of autoantibodies present, but the family history should be additionally considered for individual risk assessment. The proposed screening strategy could overcome the inherent problems of the ICA and IAA assays for large-scale screening. In the present study it allows 5-year risk estimates of up to 67% identifying 94% of future cases of type I diabetes.

Adult↗

PubMed1985

Below-knee reconstructions with the human umbilical veins--three-year results.

Arterial reconstructions in high flow, low resistance locations (aorta, iliac and common femoral arteries) usually have good long-term results. The late failure rate of below-knee arterial grafts is significantly higher because of their considerable length, the limited outflow bed and the small diameters (low flow, high resistance). In addition, there is the biomechanical stress with genuflexion. Apart from the operative technique and patient-specific vascular morphology, the long-term success of crural reconstructions depends largely on the type of arterial substitute. Based on a retrospective study, we have examined the influence of the bypass material in infragenicular reconstructions with distal popliteal, and with crural, insertion. The three-year patency (life-table method) in reconstructions with distal popliteal insertion was 83% for autologous vein grafts and 72% for umbilical vein grafts. In reconstructions with crural insertion patency was 62% for autologous veins, 50% for umbilical veins and 26% for PTFE grafts. Graft-specific early and late morphologic changes influencing the long-term performance have been analyzed by follow-up angiograms, and in some cases by macroscopic and histologic examination.

Actuarial Analysis↗

PubMed1984

Biogenic grafts in arterial surgery--long-term results (I. The homologous vein--II. The modified heterologous bovine carotid artery--III. The human umbilical vein).

This report summarizes the authors' experience with homologous vein grafts, modified heterologous bovine carotid artery grafts and human umbilical vein grafts in reconstructive vascular surgery. The homologous saphenous vein, taken from living donors, was implanted in 21 patients. The high percentage of early and late complications (28% and 38%, respectively), the difficult availability and the development of modern materials appear to suggest that these grafts, at least the type used in this study, should no longer be employed. The experience with 102 femoro-popliteal and femoro-tibial bypasses in 140 revascularization operations carried out with modified heterologous bovine carotid artery grafts (Solcograft) is presented. The cumulative patency rate was 43% after 5 years for the above-knee and 33% for the below-knee femoro-popliteal bypasses. The high early and late complication rates (37% and 35%) lead us to believe that this graft should also no longer be employed. The human umbilical cord vein (Meadox-Dardik-Biograft) was used in performing 68 femoro-popliteal and 15 femoro-crural bypasses in 60 limbs of 57 patients. The patency rates calculated according to the standard life table method was 36% for the above-knee (after 5 years) and 32% for the below-knee femoro-popliteal bypass (after 4 years) and 31% (after 3 years) for the femoro-tibial bypass, respectively. On the understanding that other materials should be preferred in the individual case, this material still seems to be recommendable as a graft of second or third choice.

Adolescent↗

PubMedDate not supplied

[Effect of dose intensity and therapy-induced leukocytopenia in intensive therapy on the prognosis of acute lymphatic leukemia in childhood. Results in 213 patients of the COALL-85 study].

Dose intensity (DI) plays an important role in the treatment of neoplastic diseases. The individual DI within a protocol may vary considerably and thus may be an important prognostic factor. In 213/305 patients treated in the cooperative study COALL-85 for childhood acute lymphoblastic leukemia the following parameters of individual therapy intensity were analyzed: Total time for intensive treatment, cumulative doses of single drugs, mean relative dose (= relation between received and prescribed doses of all drugs), mean relative dose intensity ( = mean relative dose/time) as well as frequency and duration of leukocytopenia. Therapy for LR (low-risk) and HR (high-risk) patients were separately analyzed by both life-table method and multivariate regression analysis. Neither length of time, mean relative dose intensity nor the other parameters had any significant influence on prognosis within the HR protocol. The only significant prognostic factor was the remission status on day 28 (p less than 0.001 in multivariate analysis). In contrast patients treated with the LR protocol had significantly fewer relapses if treatment resulted in leukocytopenic episodes (probability for event free survival (EFS) = 0.76 in patients with one or two leukocytopenic episodes compared to 0.52 in patients with none). Patients with a mean relative dose greater than 0.9 showed a higher EFS of borderline significance than patients with mean relative dose less than = 0.9 (0.72 vs 0.49, p = 0.09). We would like to conclude, that treatment protocols with very intensive and prolonged combination chemotherapy have a certain margin of safety in DI without disadvantage for the patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1990

[Value of irradiation alone of generally inoperable endometrial cancer with high dose rate iridium 192].

Surgery should be an integral part of the management of the patient suffering from endometrial cancer. Only patients with severe internal diseases should be treated with radiation therapy alone. Although radiation therapy alone can cure endometrial cancer, the survival figures are poorer than for the operation. At the University of Vienna (1st Department of Gynaecology), 267 patients with endometrial cancer were treated by radiation therapy alone (Afterloading iridium192 technique). 5-year survival (life table method) for all patients was 65.2%. In stage I, 5-year survival was 66.9%, and in stage II 46.7%, respectively. For up to 69 years of age the survival was 76.6%, for 70 years and more 61.8%, for grading I 78.8%, for grading II and III only 55.4%, respectively. With radium226 technique, the survival rate was only 56%, while 65.2% were reached with the Iridium technique. All differences are significant. External irradiation (cobalt60) was employed as combined treatment in only 9.4% of the cases. Intrauterine and intravaginal applications were performed without anaesthesia and the hospitalisation time was only one day per week. The relapse rate in stage I/b was 14.8% and in stage II 30%, respectively. Therefore, the dose of intracavitary treatment should be changed and external irradiation used more often.

Aged↗

PubMed1989

[The value of postoperative irradiation in endometrial cancer of pathohistologic stage I].

In a prospective therapeutic study, 571 cases of endometrial cancer in pathological stage I were treated initially with total hysterectomy and received 6 weeks after surgery double high-dose-rate iridium 192 irradiation of the vagina (afterloading technique). The single dose was 700 cGY (at 2 cm distance from the applicator axis). Postoperative treatment planning was based on the prognosticators of depth of myometrial invasion and tumor grading with subtypes. External irradiation was prescribed only for patients with poor prognostic factors (Cobalt-60,5600 cGY on the pelvis wall, 30 fractions). At the time of this report, the patients had been followed up for 6 to 96 months after their original therapy. Survival was calculated by the life table method. 327 cases with slight tumor infiltration, independent of the tumor morphology, received postoperative vaginal irradiation only. Survival rate was 90.6%. 27 cases with tumor infiltration of the middle third of the myometrium and grade 1 tumors, received also only vaginal irradiation. Survival rate was 100%. 101 cases with tumor infiltration of the middle third of the myometrium and grade 2 and 3 tumors, received vaginal irradiation plus external irradiation. Survival rate was 89.9%. 116 cases with tumor infiltration of the external third of the mymetrium and any tumor grade, received vaginal irradiation plus also external irradiation. In these patients with poor prognosis, the survival rate was 85%. Differences between groups are not significant. Considering the treatment group with good prognosis and the group with poorer prognosis and the additional external irradiation, the survival figures were quite similar (90.6% and 87.9% respectively). In spite of the unfavorable situation of patients with poor prognosticators, treatment results after the additional external irradiation were rather similar to those cases with good prognosticators and without external irradiation. The value of external irradiation in cases of endometrial cancer in stage I with unfavorable prognosticators seems to be quite clear. This therapy improvement was all the better, because side effects of external irradiation were low (0.2% rectovaginal fistulas) and in case of irradiation of the vagina only, no severe side effects occurred. Relapse rate for the treatment group with good prognosis and vaginal irradiation only was 0.6% (2 from 354) and for the group with poor prognosis and additional external irradiation 2.8% (6 from 217) respectively.

Adult↗

PubMed1980

[Long-term experience in intrauterine contraception a comparison between Lippes' loop, Dalcon-shield and copper-t (author's transl)].

Three different models of intrauterine pessaries are compared with each other in respect of tolerance and safety. They were worn for different lengths of time, partly for up to ten years. The comparison shows that the Pearl index in its conventional form is not a suitable indicator. It does provide a pointer if the individual collectives are reduced to the same wearing period. The Life-Table method yields better results. It relates the events for a total of 100 women in each case to the same interval periods. This shows that the most favourable rate of complications and quota of failures is obtained with Cu-T 200. During the first three years this quota decreases steadily. Hence it is recommended to effect intrauterine contraception according to this model wherever suitable and to allow Cu-T to be retained in position for at least three years if it is well tolerated.

Adult↗

PubMed1984

[Survival after treatment for malignant choroidal melanoma: comparison between conservative therapy (Ru106/Rh106 applicator) and enucleation with and without postoperative irradiation to the orbit; 1960 to 1979].

The survival rate was calculated using the life table method in 1,501 patients suffering from choroidal melanomas and treated in 10 eye hospitals in the GDR between 1960 and 1979. The results of treatment by (1) enucleation, (2) enucleation with postoperative irradiation of the orbit and (3) local irradiation with 106Ru/106Rh were compared. The 10-year survival rate in patients treated by 106Ru/106Rh irradiation (n = 187) was 72%; in a group of patients similar with regard to age, tumor size and cell type, but who had undergone enucleation (n = 241) the 10-year survival rate was 49%. This clearly indicates that irradiation of small melanomas with 106Ru/106Rh applicators (tumor base not larger than 10 mm, tumor height not more than 2 mm) produces the best therapeutic results. There was no statistically proven difference between survival rates in patients treated with enucleation and enucleation combined with postoperative irradiation of the orbit. Postoperative irradiation of the orbit does not improve the survival rate. The 10-year survival rate in patients aged up to 49 years was 83% after 106Ru/106Rh and 81% after enucleation; it was not possible to prove a difference statistically. The 10-year survival rate in patients aged between 50 and 69 years was 80% after 106Ru/106Rh (n = 93) and 46% after enucleation (n = 146). The superiority of local beta irradiation was statistically proven. The expected survival of people aged 70 years and over was affected neither by the choroidal melanoma nor by different therapeutic procedures.

Adult↗