[Expression of Bcl-2 antigen in laryngeal carcinoma]. / Ekspresja antygenu BCL-2 w raku krtani.

The results of immunohistochemical investigations of BCL-2 presence in 50 patients with laryngeal carcinoma were presented. In 14% of all investigated cases presence of BCL-2 protein was observed. In patients with advanced clinical stage of laryngeal carcinoma higher expression of BCL-2 protein comparing with patients with lower clinical stages was more frequently observed--but it wasn't significant. No significant difference in presence of BCL-2 protein among the patients with a different stage of histological differentiation of carcinoma and among the patients with present and absent metastatic changes in regional lymph nodes was observed.

[The use of microsurgery and balneotherapy in the treatment of hyperplastic laryngitis]. / Zastosowanie mikrochirurgii i balneoterapii w skojarzonym leczeniu hiperplastycznych niezytów krtani.

The study aimed at the assessment of the clinical value of using the combined method of laryngeal microsurgery and balneotherapy in the operative treatment and prevention of recurrences of limited hyperplastic changes of the laryngeal mucosa. The study material comprised two groups of patients diagnosed and treated in the years 1991-1997 in the Lublin E.N.T. Department and Laryngological Research-Consulting Center in Iwonicz Zdrój. The I clinical group consisted of 194 patients in whom, on definite indications, micro-surgeries with Kleinsasser's method were performed and the II control group consisting of 165 subjects suffering from chronic simple inflammation of pharyngo-laryngeal mucosa without morphologic hypertrophy. Inhalant treatment was performed by means of an individual method--using inhalant devices by Thomex L-2 producing high density mist of 1-4 mu degree comminution. Isotonic Iwonicz saline-Elin 7 was used. Uniform criteria of assessment were assumed and used of direct and distant therapeutic effect (in control studies) for the whole group of patients in the study period. Obtained results were analysed statistically.

[Expression of p53 antigen in laryngeal carcinoma]. / Ekspresja antygenu p53 w raku krtani.

The results of immunohistochemical investigations of p53 presence in 50 patients with laryngeal carcinoma were presented. In the whole investigated group the presence of p53 protein in 90% of all investigated cases was observed. In patients with advanced clinical stage of laryngeal carcinoma higher expression of p53 protein comparing with patients with lower clinical stages was more frequently observed--but it wasn't significant. No significant difference in presence of p53 protein among the patients with a different stage of histological differentiation of carcinoma and among the patients with present and absent metastatic changes in regional lymph nodes was observed.

[The results of surgical treatment of patients with laryngeal carcinoma in years 1988-1989 in four departments of otorhinolaryngology]. / Wyniki operacyjnego leczenia chorych na raka krtani w latach 1988-1989 w czterech osrodkach klinicznych.

In a group of 579 patients with laryngeal carcinoma treated surgically in years 1988-1989 in four departments of otorhinolaryngology of the Medical Academies in Poznan, Warsaw, Cracow and Lublin, 72% survived 3 years without recurrence and 59% survived 5 years. Similar results were obtained in years 1986-1987. The authors discuss in detail the reasons for failures of the surgical treatment, i.e.: supraglottic localization of the cancer, its extensiveness in the larynx, the stage of clinical development, general condition of the patient, effectiveness of the operation, regularity of postsurgical examination, the degree of histological malignancy, blood transfusion during the operation, distant metastases, little efficiency of medical service in early diagnosis of laryngeal cancer, avoiding postsurgical radiation, subjective factors of the patients and the choice of the optimal method of the treatment. Few patients can be cured if the initial treatment fails.

[Epidemiologic and clinical tests of patients suffering from laryngeal cancer in the Lublin macro-region in the years 1991-1995]. / Badania epidemiologiczne i kliniczne chorujacych na raka krtani w latach 1991-1995 w makroregionie lubelskim.

The study of registered morbidity of patients suffering from laryngeal cancer in the Lublin macro-region in the years 1991-95 was carried out. Morbidity rates in the population in consecutive years of investigated 5-year age groups were examined. In clinical investigations the conditions of clinical advancement of the disease in particular organs was determined and environmental factors and occupation were also revealed.

[Efficiency of surgical treatment in patients with laryngeal cancer depending on age]. / Wydolnosc operacyjnego leczenia chorych na raka krtani w zaleznosci od wieku.

In the group of 578 patients with larynx cancer that underwent surgical treatment in four clinics of Medical Academies between 1986-87 a comparable analysis of the efficiency of surgical treatment depending on age of the operated patients was carried out. It was found that the difference between age average and the general state of patients was statistically highly important: Statistically significant was also the dependence between the patients' age and the postoperative complications; close to importance was also the dependence between the age and the survival period of patients. 68% of operated patients up to 65 year of age had five-year survival period without any symptoms; but in the group of patients over 65 years of age the analogical survival value was 51%.

[The reasons for failures of laryngeal cancer surgeries]. / Przyczyny niepowodzen operacyjnego leczenia chorych na raka krtani.

In 4 ENT Clinics of Medical Academies in Poznan, Warszawa, Kraków, Lublin 2620 laryngeal cancer patients were operated upon during the years 1980-1987. The treatment failure occurred in 760 cases (29%). The following possible to discover factors were probably responsible for unsuccessful results: senility, other concomitant diseases (especially cardiac), prolonged diagnostic procedure, no up to date diagnostic methods, giving up the radiotherapy (38% of cases), upper laryngeal localization of tumors (87%), advanced extents T3 and T4 (83%), advanced clinical stages of cancer (III degrees and IV degrees 85%), lack of surgical radicality especially in neck dissection, unsuccessful neck dissection behind the accessory nerve, omittance of taking the specimens to the pathomorphologic examinations from the marginal part of the operational field in 25% of patients. The early recurrences in these places in apart of patients spoke for the presence of the neoplasmatic cells in this region.

[Epidemiologic and clinical investigations of patients suffering from laryngeal neoplasms in the Lublin region in the years 1991-1994]. / Badania epidemiologiczne i kliniczne chorujacych na raka krtani w makroregionie lubelskim w latach 1991-1994.

Investigations of larynx cancer rate of Lublin population were carried out in the years 1991-1994. Factors of the community rates in each year and in five-years age group were determined. 681 suffering people were examined clinically. The clinical stage and degree of organ involvement were appointed.

[Failure of surgical treatment in patients with laryngeal cancer]. / Niepowodzenia operacyjnego leczenia chorych na raka krtani.

In 4 ENT Clinics of Medical Akademies in Poznan, Warszawa, Kraków, Lublin 2620 laryngeal cancer patients were operated upon during the years 1980-1987. The treatment failure occurred in 760 cases (29%). The following possible to discover factors were probably responsible for unsuccessful results: prolonged diagnostic procedure, upper laryngeal localization of tumors, advanced extents T3 and T4 (83%), advanced clinical stages of cancer (III degree and IV degree 85%), lack of surgical radicality especially in neck dissection. The early recurrencies in these places in apart of patients spoke for the presence of the neoplasmatic cells in this region.

[Efficiency of surgical treatment in patients with laryngeal cancer in four clinical centers]. / Wydolnosc operacyjnego leczenia chorych na raka krtani w czterech osrodkach klinicznych.

A group of 578 patients with larynx cancer underwent surgical treatment in four Otolaryngological Clinics of Medical Universities in Poznan, Warsaw, Cracow and Lublin between 1986-1987. Within this group, 75% of operated patients had a three--year survival rate without symptoms, and 58% of patients had a five-year survival rate. A detailed evaluation of causes of failures in surgical treatment dealt with e.g. the initial placement of the cancer including entrance margins of larynx in a rich net of lymphatic vessels, extensiveness of organs, the degree of clinical progressions, general physical condition of a patient, radicality of treatment, regularity of check-ups after the operation, high degree of histological malignancy unfavourable configuration of TNM feature blood transfusions, the appearance of remote metastases low efficiency in the early diagnostics of larynx cancer, subjective conditions of patients, discontinuation of complementary irradiation.

[Use of computerized tomography in topographic diagnosis of salivary gland tumors]. / Zastosowanie tomografii komputerowej w ocenie topograficznej guzów slinianek.

In the radiologic assessment of extension tumors of parotid glands CT method was used and for comparative purposes sialography was performed. In comparative analysis there was assessed CT method and its usefulness in the preoperative assessment of tumor extension.

[Analysis of the causes of failure in surgical treatment of cancer of the larynx]. / Analiza przyczyn niepowodzen leczenia operacyjnego chorych na raka krtani.

In the years 1985-1990 within the group of 2769 patients operated upon for laryngeal cancer in four medical centres (Kraków, Poznan, Warszawa, Lublin), a clinical analysis on surgical treatment failures was performed. The most significant reasons of failures were: the highly advanced age of patients, coexistent diseases, in particular the cardiopulmonary disease; poor information of neoplastic diseases (carcinomas) and delayed referral to the doctor; lack of consent for surgical treatment; old fashioned diagnostic methods; prolonged period of making diagnosis; increasing number of patients with supra-glottic localization including the hypo-pharynx and piriform recess; a considerable degree of organ ++cancer advancement and substantial clinical advancement; not radical excision of neck glands; intra-surgical blood transfusion; micrometastases to lymphatic glands; immunity collapse; discontinuance of post-surgical radiation on affected parts; lack of lymphadenectomy backward from accessory nerve ; massive cancer metastases to lymph nodes; high histologic malignancy with characteristic carcinous invasiveness; and finally, surgical and post-surgical early and late complications ranginy within our material from 25% to 29% of surgical patients. Basing on the above mentioned analysis, the authors developed indications for surgical treatment of laryngeal cancer.

[Evaluation of the effectiveness of surgical treatment of metastases of laryngeal cancer to the lymph nodes]. / Ocena wydolnosci leczenia operacyjnego przerzutów raka krtani do wezlów chlonnych.

The evaluation of surgical treatment results was done to 308 oncological patients to whom metastases were formed in lymph nodes between 1980-1984, following the previous surgical treatment of the laryngeal cancer. The evaluation included among others the following: cancer initial localization: T and N traits; the degree of malignancy; surgical radical intervention ; assertion of neoplastic cell plugs in vessels; the time of recurrent lymphatic metastases, etc. The efficiency of surgical treatment of metastases being formed following the previous surgical treatment of laryngeal cancer, measured by the time of 5 years asymptomatic life, equalled 33.4% in the discussed material. Moreover, it was stated that in the studied group of 308 patients the percentage of deaths was increasing in the subsequent years of taking observations (from 1980 to 1984) and depended also on patients overall condition, initial cancer localization, the degree of neoplastic advancement and on the degree of cancer histologic malignancy.

[Evaluation of the causes of lymphatic metastases after surgical treatment of patients with laryngeal cancer]. / Ocena przyczyn powstawania przerzutów do wezlów chlonnych po leczeniu operacyjnym chorych na raka krtani.

During the years 1980-1988 2458 laryngeal cancer patients were operated upon in 4 ENT AM Clinics in Kraków, Poznan, Lublin and Warszawa. 300 (12%) out of them have had the cervical node metastases in 18 months after the surgery. The cause analysis was performed. The primary localizations were in the epiglottic and ++post-cricoid areas. The causes of metastases to the ++lymph nodes were analyzed; the primary epiglottic and ++post-cricoid localization of the tumor, its extensiveness and advanced clinical stage. Twice more often were the nodal metastases stated before the primary treatment, a high degree of histological malignancy, probably insufficient radicality of the surgery and insufficient immunological resistance of the organism were taken in consideration. This group of patients presented a rather high percentage of early unsuccessful results of surgical treatment of the laryngeal cancer; this problem needs further analysis and observations.

[Evaluation of complications after surgical treatment of cancer of the larynx]. / Ocena powiklan po leczeniu operacyjnym chorych na raka krtani.

The surgical complications in a group of 1712 laryngeal cancer patients treated during the years 1981-87 in ENT Clinics of Cracow, Poznan, Warsaw and Lublin were described. The most dangerous were bleedings and the most frequent wound and tracheo-+-bronchial infections and pharyngo-cutaneous fistulas++, after radical neck dissection however the paralysis of sublingual and accessory nerves and of brachial plexus. The predisposing factors were: diabetes, lung and heart diseases, late stage of cancer, extent of surgery and tumor infections.