[Preoperative localization of pathologic findings in mammography]. / Präoperative Lokalisation pathologischer Befunde in der Mammographie.

Pre-operative localization of abnormal findings during mammography makes it easier to find the lesions if they are not palpable. Our study is based on 373 procedures, using a "harpoon" needle. Radiographs of the operative specimen showed that 66% of the lesions had been completely removed, 15% had been partially removed and 19% could not be identified unequivocally. 172 patients had subsequent mammograms. Amongst these, the lesion had been completely removed in 70%, partially removed in 14% and in 10% it was still present. In 62% dense scar formation made it impossible to be certain whether excision had been complete.

Operative therapy for stage IIb cervical cancer.

A total of 506 cases of cervical cancer, Stages Ib and IIb, operated on according to Wertheim and Meigs, were retrospectively (1972-1985) evaluated with respect to their clinical and morphological aspects. After 1978 a more intensive histological evaluation of the specimen was performed, resulting in the examination of a larger number of pelvic lymph nodes. The number of lymph nodes infiltrated depends on tumour stage, invasion depth, regional lymphovascular invasion of the tumour edge and parametria, and on haemangiosis carcinomatosa. The five-year survival rates were determined by the parametrial infiltration and by the number of positive pelvic lymph nodes. If neither the parametria nor the lymph nodes were infiltrated by the tumour the survival rate was 69%, whereas in cases of lymphovascular invasion of the parametria without infiltrated lymph nodes the rate decreases to 80%; in cases of tumour infiltration of both lymph nodes and parametria the cure rates are worst (62%). The operation on cervical cancer of Stages Ib and IIb with a thorough histological evaluation of the excised tissue therefore has a high prognostic value, but it also probably has better cure rates than is the case with radiological treatment.

[Results of 108 exenteration operations in advanced gynecologic cancers]. / Ergebnisse von 108 Exenterationsoperationen bei fortgeschrittenen gynäkologischen Karzinomen.

We can now say that in our opinion exenteration is not an operation that is dangerous to life, if the conditions that will be described below are observed and if the indication is interpreted sufficiently narrowly, although during the first few years results had been moderate indeed. Exenteration has since developed so positively that it is now increasingly possible to consider the aspect of preserving the function of the adjacent organs, so that the disadvantages resulting for the patient's own body image and her self-concept and self-appraisal are now relatively acceptable compared to what had been possible previously. Indication for exenteration results from the situation, the ideas and the motivation of the patient, mainly, however, against the background of the characteristic features of the operation described here. Today we can say that even these extensive operations are firmly established in gynaecological oncology if there are extended carcinomas and recurring carcinomas. Hence, I believe it is advisable--at least in central recurring carcinomas--to refer such patients to competent surgical oncological centres before attempting to irradiate (or to irradiate again) the recurring tumour.