[Effect of ethanol on N-nitrososarcosine ethyl ester-induced carcinogenesis in the esophageal and forestomach mucosa of mongrel rats]. / Vliianie étanola na kantserogenez, indutsirovannyi étilovym éfirom N-nitrozosarkozina v slizistoi obolochke pishchevoda i predzheludka nelineinykh krys.

Administration of N-nitrososarcosine ethyl ether (50 mg/kg, per os, every day during 4 months) to rats induced after 8 months multiple tumours (most often papillomas) of oesophagus and forestomach. Total incidence of tumour-bearing animals was 42.4% in oesophagus and 21.2% in forestomach, distribution of tumours being 85.6 and 14.4%, respectively. The combined administration of carcinogen with 40% water solution of ethanol (0.5 ml, per os, every day during 8 months) did not change general incidence and multiplicity of all tumours, but decreased the relative incidence of oesophagus tumours and increased that of forestomach tumours. Possible mechanisms of organotropism shifts are discussed.

[Supplementary morphological criteria F anf G in the classification of esophageal cancer by the TNM system]. / Dopolnitel'nye morfologicheskie kriterii F i G v klassifikatsii raka pishchevoda po sisteme TNM.

Additional criteria are introduced for the prognosis of esophageal carcinoma: anatomical form of growth (F) and the degree of carcinoma differentiation (G). These conclusions are drawn basing on long-term results of treatment of 302 patients. These additional criteria help to make a proper choice of treatment. The best results may be expected under the following combination--T1P1-2N0M0F1G1, 5-year survival in these patients was 69.8%. Unfavourable results were in the group of radically treated patients with the following combination T3P3N1M0F1-3G3bv, 5-year survival being 7.8% only.

[Non-organ tumors of the lesser pelvis]. / Neorgannye opukholi malogo taza.

An analysis of the author's findings showed a correlation between clinical manifestations of tumor, on the one hand, and its growth rate, size and, to a lesser degree, morphological pattern, on the other. Large size of tumor should not necessarily be interpreted as an indication of inoperability. A better 5-year survival following surgery in benign tumor group (82.1%) as compared with malignant tumors (24.5%) was confirmed.

[Combined surgery in cancer of the proximal section of the stomach]. / Kombinirovannye operatsii pri rake proksimal'nogo otdela zheludka.

The investigation showed combined surgery for cancer of the gastric cardia to be justified from the oncological point of view. Such intervention reaches out to the limit of radical treatment. However, combined surgery should not be performed unless there are substantial indications. Basic indications for excision or resection of an adjacent organ should be gastric tumor extension through organs and tissue or dissemination to the regional lymph nodes which cannot be radically removed unless surgery is performed on adjacent organs.

[Clinical TNM classification of malignant soft tissue neoplasms]. / O klinicheskoi klassifikatsii zlokachestvennykh opukholei miagkikh tkanei po sisteme TNM.

A project for the classification of malignant soft tissue tumors according to the TNM system is suggested for a wide discussion. The classification takes into account the effect of some leading factors (histological type of a tumor, its size, the state of regional lymph nodes, the degree of the adjacent tissues infiltration) on the prognosis of this affection. Tumors staging is done through combining various grades of T, N, M criteria.

[Combined operations for non-organ retroperitoneal tumors]. / Kombinirovannye operatsii pri neorgannykh opukholiakh zabriushinnogo prostranstva.

Incision biopsy of skin melanoma is performed after forming a circular blocking barrier by means of a laser beam. Once tumor proper is subsequently irradiated, this prevents dissemination of tumor process. Skin melanomas, degree I-IV invasion (Clark), and 4.5 mm thick (Breslow) are effectively treated by pulsed laser radiation.

[Analysis of the reasons for the refusal of surgical treatment among esophageal cancer patients]. / Analiz prichin otkaza ot operativnogo lecheniia u bol'nykh rakom pishchevoda.

Data on 544 patients with esophageal cancer are reported. The main reasons of their refusing the radical treatment were as follows: 1) a considerable local tumor proliferation (31.8%); 2) senile age, concomitant diseases, a general poor condition of patients (25.6%); 3) the presence of distant metastases (11.4%); 4) location of a tumor in the jugular or upper thoracic esophagus for which palliative radiotherapy was performed, but in some cases a palliative surgery (9.7%); 5) fear of surgery (15.4%); 6) no reason (6.4%).

[The choice of the extent of the surgical intervention in patients with soft-tissue tumors of the trunk]. / Vybor ob''ema operativnogo vmeshatel'stva u bol'nykh s opukholiami miagkikh tkanei tulovishcha.

Data on 145 cases of soft-tissue tumor of the trunk were analysed. Tumor was located on the chest or back in 81 patients and deep in the anterior abdominal wall--in 64. When intramuscular sarcoma is removed, a 2-3-cm margin should be left around the palpable mass. Five-year survival in the entire group of patients with tumors of the chest and back was 59.4% +/- 2.4. Five out of ten cases with tumor of the abdominal wall survived over 5 years.

[The choice of the extent of the surgical intervention in patients with soft tissue sarcomas of the extremities]. / Vybor ob''ema operativnogo vmeshatel'stva u bol'nykh s sarkomami miagkikh tkanei konechnostei.

The analysis of data on 446 patients with soft tissue malignancies showed overall five-year survival rate to be 48.9%. The extent of tissue to be removed during sparing surgery is specified. In case of intramuscular location of tumor, it is enough to leave a 4-5-cm margin above and below the tumor border, as assessed by palpation. Indications for limb amputation at various levels were developed. Limb-sparing surgery could be employed on a larger scale if advances of modern plastic (skin, bone and vascular) surgery were adopted wider. A complex of rehabilitative measures was developed. Patients undergoing limb amputation need early prosthetics.

[Recurrent nonorganic tumors of the lesser pelvis]. / Retsidivy neorgannykh opukholei malogo taza.

The authors' findings on 16 cases of small pelvis nonorganic tumor recurrence are presented and relevant recommendations on diagnosis and treatment are given.

[The prognostic significance of the anatomical forms of esophageal cancer]. / Prognosticheskoe znachenie anatomicheskikh form raka pishchevoda.

Among the great variety of anatomic patterns of esophageal cancer growth, three basic patterns--exophytic, mixed and endophytic--should be distinguished. Anatomic pattern of growth is one of the basic prognostic criteria for tumor stage assessment. This finding is supported by five-year survival evidence for cases of radical surgery: 58.8 +/- 10% with exophytic form, 16.6 +/- 10%--ulcerative infiltrative and 3.3 +/- 6% with diffuse infiltrative pattern of tumor growth.

[Potentials of pneumomediastinography in precisely determining the degree of esophageal cancer spread]. / Vozmozhnosti pnevmomediastinografii v utochnenii stepeni rasprostraneniia raka pishchevoda.

The data presented evidence that parietography is a valuable adjunct to routine roentgenological examination. One of the most complicated problems to be solved by this technic is whether the tumor invaded the adjacent structures, and also its relation to the surrounding tissues and mediastinal organs.

[Dosimetric analysis of radiation treatment methods in cancer of the middle 3rd of the esophagus using the Rokus gamma apparatus]. / Dozimetricheskii analiz nekotorykh metodik luchevogo lecheniia raka srednei treti pishchevoda na gamma-apparate Rokus.

By means of an electronic computer various standard technics of irradiation for cancer of the middle esophagus are compared as to the basic dosimetry range with the schedule of irradiation, calculated according to the program of the optimum dosimetry level. The criterion of the optimum dosimetry level was the requirement of a minimum integral dose in patient's body under even irradiation of the tumor zone (circular area with a diameter of 6 cm) but not less than 80% of the dosage in the esophagus center. The technics under stude show that rotation irradiation through 360 degrees provide the nearest approximation to the optimum regime.

[Clinical introduction and results of simultaneous resection and repair in esophageal cancer]. / Rezul'taty odnomomentnykh rezektsii i èzofagoplastiki pri rake pishchevoda na ètapakh klinicheskogo vnedreniia.

The data on 80 cases of radical resection and extirpation of the esophagus for intrathoracic tumors entailing esophagogastroplasty are discussed. Esophageal extirpation with resection of the proximal part of the stomach, sufficient lymphadenectomy, simultaneous transmedianal esophagogastroplasty and formation of cervical esophago-gastrostomy proved the most radical. The 3-year complication and mortality rates were 20.0 and 5.0%, respectively. The procedure yields the best functional results, too. It is understood that the long and tortuous process of development of a new surgical procedure inevitably involves frequent postoperative complications, which, however, can be effectively treated if measures are taken to improve surgical technique and intensive care standards. The end-results still leave much to be desired--the 3-year survival rate was 24.0, 5 years--8.0%.

[An analysis of the work activities and survival of patients operated on for stomach cancer]. / Analiz trudovoi deiatel'nosti i vyzhivaemosti bol'nykh, operirovannykh po povodu raka zheludka.

The paper deals with the analysis of dynamics of working activity of 146 radically treated gastric cancer patients examined by the Oncological Commission for Ability Expertise of Novosibirsk in 1984-1988 and then followed for 2-5 years. The percentage of patients returning to work was the highest during the first and third years posttreatment. This was attributed to extension of temporary invalidity period and rehabilitation of group 2 invalids, respectively. Lethality among patients returning to work was 8.2 +/- 2.3% as compared to 62.6 +/- 2.5% in a group of 385 patients who did not work. Labor activity did not adversely influence the clinical course of disease. The unfavorable course was attributed to biological properties of tumor such as low degree of differentiation and infiltrative pattern of growth.

[Stimulating effects of 3% acetic acid on the induction of esophageal tumors in rats]. / Stimuliruiushchee vliianie 3% uksusnoi kisloty na induktsiiu opukholei pishchevoda u krys.

The probe--mediated intragastric injection of 50 mg/kg ethyl ether of N-nitrososarcosine (EENS) 5 times a week for 6 months was followed by the development of multiple tumors in 91.8% of 120 noninbred male rats supplied by a local animal farm: esophagus--85.7%, fore-stomach--73.4% and throat--22.4%. The lesions in the esophagus and the fore-stomach entry were similarly frequent (61.2-75.5%) which was matched by a much lower incidence rate (22.4%) for the remaining parts of the fore-stomach. The combined intragastric injection of 3% acetic acid (0.5 ml thrice a week) for 8 months and EENS for 6 months boosted the total frequency of neoplasms to 100% and resulted in increased multiplicity of tumor--from 9.8--10.7 for EENS alone to 14.5 for EENS + acetic acid. Most lesions occurred in the fore-stomach entry as far as the level of tumor (squamous cell carcinoma and papilloma) development, frequency and relative risk (number of tumors. v. actual number of animals) are concerned. A long--term treatment with 3% acetic acid alone was followed by chronic inflammation of the esophageal mucosa rather than tumor development.

[Comparative evaluation of surgical and combined treatment of cancer of the proximal region of the stomach]. / Sravnitel'naia otsenka khirurgicheskogo i kombinirovannogo lecheniia raka proksimal'nogo otdela zheludka.

The paper deals with an analysis of the results of treatment of 351 cases of radical surgery for cancer of the proximal part of the stomach (surgery-303, surgery + preoperative large-fractionated radiation-48). It was found that radiation was not followed by increased blood loss during operation nor did it interfere with application of any surgical procedure. Concentrated irradiation did not involve an increment in postoperative lethality and complication rates. Five-year survival rates were 37.4 +/- 8.0 in cases of combined treatment and 20.4 +/- 2.7% in those of surgery. The improvement in survival rates recorded in cases of combined treatment was largely due to a decreased incidence of local recurrences.

[Medical care for patients with cancer of the upper thoracic segment of the esophagus]. / Lechebnaia pomoshch' bol'nym rakom verkhnegrudnogo otdela pishchevoda.

Out of 350 hospitalized cases of esophageal carcinoma in the upper thoracic segment, stage III-IV tumors were identified in 82.8%. A retarded seeking of medical advice was chiefly responsible for the advancement of tumors. Radical surgery was performed in 32 (9.1%) patients only. The percentage of radically-treated cases could have been greater, if there had been fewer refusals to operate and to be operated on both on the part of patients and doctors who would object to surgery on the grounds of concomitant pathology or the patient's age. Radiotherapy, used in 197 (72.7%) patients as a sole method of treatment, was followed by remission in 68%.

[Endoscopic diagnosis of tumors of the esophagus]. / Endoskopicheskaia diagnostika opukholei pishchevoda.

The analysis of the data reported indicates that fibroesophagoscopy is a valuable adjunct in the diagnosis of esophageal cancer, which may be used both under stationary and outpatient conditions. The latter is of special importance for prophylactic examinations of high-risk group individuals. The possibility to establish histological and cytologic diagnosis by means of this method of investigation is essential for tactical aspects of the treatment in such patients. The use of roentgenological and endoscopic methods of study allows a more precise judgement to be formed as to the character of esophageal involvement.

[Role of radiation therapy in the combined treatment of soft tissue liposarcomas]. / Rol' luchevoi terapii v kombinirovannom lechenii liposarkom miagkikh tkanei.

The end results of surgical and combination (radiation + surgery) treatment of 85 patients with liposarcoma are compared. The 5-year survival rate following combination therapy proved to be much higher than after surgery (84 and 53.4%, respectively). Application of radiation improves the results for treatment of all histological types of tumor, polymorphocellular liposarcoma included. Indications of standard and concentrated dose-fractionated radiation should be determined by the size of tumor.