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The categorization of lymphosarcomas with immune markers has enriched the prognosis value of the WHO classification. The prolymphocytic (centrofollicular) B-type and the null lymphoblastic subtype have a good prognosis, while the (T- or B-) immunoblastic type and the T-lymphoblastic subtype have a poor prognosis.
The biological characteristics of supraglottic carcinoma was studied with special reference to the correlations of various biological factors with the prognosis of the lesion. The study included 100 cases of supraglottic carcinoma treated by total laryngectomy in the First Hospital of China Medical University in the period from 1975 to 1978, and 7 factors including histopathological findings observed in serial sections of the whole larynx, clinical findings, clinical course, etc. These factors were statistically analyzed by multiple correlation analysis using the theory of quantification I to determine the relations of these factors to the prognosis, as well as their participations in post operative course. 1. Twenty-seven cases died within 5 years after surgery, and 4 cases could not be followed up. 3 and 5-year survival rates were 79.5% and 72.2%, respectively, as calculated in accordance with the UICC General Rule. 2. Histopathologically 5-year survival rate was 10.0% in cases with poorly differentiated carcinoma, 78.0% in cases with moderately differentiated type, and 83.5% in cases with well-differentiated type. It was remarkably lower in poorly differentiated carcinoma than that in moderately or well-differentiated carcinoma. 3. In cases having dense lymphocyte infiltration associated with lymph follicles in peripheral region of tumor, 5-year survival rate was higher (90.4%) than in the other cases. 4. It was found that, as tumor size increased, 5-year survival rate decreased and the risk of lymph node involvement increased in the neck region. 5. 5-year survival rate was lower (48.5%) in cases with lesion infiltrating the surrounding tissues than in cases with other growth patterns. 6. Multiple correlation coefficient between prognosis and the 7 factors analyzed was 0.766. The important factors were the degree of differentiation (0.735), the degree of lymphocyte infiltration (0.260), the size of primary tumor (0.215), the growth pattern of tumor (0.141) and neck metastasis (0.028).
We have assessed the long-term prognosis about cardiac death of isolated coronary artery bypass surgery from 1972 to 1988 in 361 consecutive patients. The duration of follow-up were from 0.4 years to 14.6 (mean 5.7) years. Of the 361 study patients, the operative morality was 4.7% (17 patients) and 29 patients (8.0%) died during follow-up, 11 (3.0%) of which were from cardiac causes. Actuarial survival rate was 85.2% at 10 years after surgery. The 10 year-survival rate was similar for patients with single, double, triple vessel disease, and left main trunk disease (94.5%, 83.7%, 75.1% and 89.1%, respectively). For patients with and without old myocardial infarction, the 10 year-survival rate was significantly different (75.4% and 93.3%, respectively) (p less than 0.005). In order to detect which factors of preoperative cardiac function among cardiac index, LV end-diastolic pressure, LV end-diastolic volume index, LV end-systolic volume index, and LV ejection fraction influenced the long-term prognosis, multivariant regression analysis was performed. Only LV end-systolic volume index was a significant factor, and the discriminative point was 50 ml/m2. For patients with LV end-systolic volume index less than 50 ml/m2 and greater than or equal to 50 ml/m2, the 10 year-survival rate was significantly different (88.3% and 32.9%, respectively) (p less than 0.005). In conclusion, the most significant factor influencing longterm prognosis after coronary artery bypass surgery was left ventricular end-systolic volume, indicating the importance of preventing preoperative dilatation of left ventricle.
We found ten clusters of gastric cancer patients in Imanaga's group under a cancer research project organized by the Ministry of Health and Welfare, and evaluated the prediction of prognosis of those patients in each cluster by using the censored regression of postsurgical survival time on a "prognosic" factor which has been extracted from nine explanatory variables observed mainly at the time of surgery. Consequently, the ten clusters were interpreted and confirmed to be useful for prediction of the patient prognosis by comparison of the failure rates among those clusters and between treated (administration of chemotherapy) group and control group.
The categorisation of lymphosarcomas with immune markers has enriched the prognostic value of W.H.O. classification. The prolymphocytic (centrofollicular B type and the null lymphoblastic subtype have a good prognosis while the (T or B) immunoblastic type and the T-lymphoblastic subtype have a poor prognosis.
In a retrospective multicenter study to investigate the correlation between estrogen (ER) and/or progesterone receptors (PgR) in primary breast cancer with patient prognosis, 3118 patients with operable breast cancer (International Union Against Cancer Stages I, II, and III) were investigated from ten hospitals in Japan who underwent surgery from October 1972 to December 1982; 3089 were evaluable. The ER-positive and PgR-positive cancers were found in 56% and 34% of patients, respectively. The positivities decreased as the tumor size increased but were independent on lymph node metastasis. There were no significant differences in relapse-free survival (RFS) in relation to receptor status (median follow-up, 89 months [ER], 84 months [PgR]). However, in patients with four or more positive nodes, those with PgR-positive cancer had a longer RFS. The patients with ER-positive cancer survived significantly longer than ER-negative ones, with the greatest difference seen in those with four or more positive nodes. There was a significantly longer postrelapse survival (PRS) for patients with ER-positive cancer because of the different distribution of the major metastasis and better responses to first-line and subsequent treatments. Cox's multivariate analysis showed that overall survival but not PRS was affected by ER (and more weakly by PgR) because of the longer PRS in patients with ER-positive cancer.
In 307 patients with diabetes mellitus, developed prior to 1933 and before age 31 it was demonstrated that: (1) frequent contact with a specialized diabetes clinic from an early stage of the disease; (2) a good quality of "metabolic control"; (3) a low insulin dose; (4) a body weight of 10% less than ideal; and (5) a mean blood pressure below 100 mm Hg, all had significantly beneficial effects upon the survival. It was also found that patients domiciled in Copenhagen had a significantly better prognosis than patients domiciled outside Copenhagen. Frequent contact with a diabetes centre was accompanied by an appreciable decrease in disabling late diabetic complications.
200 cases of consecutively admitted acute myocardial infarction (AMI), who had survived for at least 2 weeks, were studied prospectively. 193 cases were followed-up for 0.5-27 (average 15) months; 41 of them (21.2%) had cardiac events, including 3 sudden cardiac death (1.6%) and 35 obvious cardiac failure (18.1%). 11 patients died of heart failure and 4 of reinfarction. Before discharge, noninvasive tests were done: LVEF < or = 40%, age > or = 60, maximum value of creatinine-phosphokinase > or = 1000 IU/dl and positive ventricular late potential were the 4 factors of high risk. Patients with 3 or 4 positive risk factors had poorer prognosis, if they were compared with those with one or none.
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1. Early detection and treatment of epidural haematoma is vital to the chance of survival. In this respect physician's training needs to be improved. 2. The operation method of choice, particularly in the case of advanced midbrain lesions, is the extensive decompression operation (hemicranectomy) with duraplasty. In each case it is imperative to pay special attention to the relationship between blood pressure and brain perfusion until the state of decompressive is reached. 3. Late complications such as a disturbed circulation of the cerebrospinal fluid may occur and should be prevented by a shunt-operation. 4. ECG changes are still detectable even after many years. However, they give little indication on the patient's tendencies to fits. Post-traumatic cases of epilepsy may even occur more than five years after injury. 5. Patients suffering from epidural haematoma are in need of careful medical, psychiatric and social care for many years after injury, even if they seem to have been restored both neurologically and psychiatrically at the time of hospital discharge.
The data of 240 patients with non-pretreated oral squamous cell carcinoma were analyzed in dependence on the tumor size (T-category), on the histologic checked lymph node status and the histopathologic grade of malignancy. There is a conformity to the results published by the DOSAK regard to the tumor size (T-category). The comparison of the survival of our patients with the estimated survival rate of the TPI shows also conformable results. Differences exist in the prognostic valuation of the lymph node status by the DOSAK. The histologic verificated lymph node status and the malignancy grade will recommend as decisionsive prognostic relevant parameters.
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