RESUMEN
AIM OF THE STUDY: The objective was the analysis of prognostic factors and treatment outcomes of 104 patients with vulvar cancer, treated between 1990 and 2003 in the Center of Oncology, Maria Sklodowska-Curie Memorial Institute, Cracow, Poland. MATERIAL AND METHODS: The median age of patients was 67. Advanced disease (TNM III and IVA) was found in 54 (51.9%) patients and grade 2 and 2 in 50 (48.1%). Inguinal lymph nodes were clinically uni- or bilaterally involved in 40.4% of patients. Fifty-seven (54.8%) patients underwent radical vulvectomy with bilateral inguinal lymphadenectomy and 47 (45.2%) radical vulvectomy only. Cancer differentiation was well in 38 (36.2%) of patients, moderate in 38 (36.2%) and poor in 28 (36.6%). Adjuvant radiotherapy was applied in 30 (28.8%) cases. RESULTS: Five-year overall survival rate was observed in 44.4% of patients. Depending on TNM grade, 5-year OS rates were 61.4% for grade 1, 54.9% for grade 2, 40.1% for grade 3 and 13.3% for IVA. In patients aged < 70, 5-year OS rate was 54.7% compared to 30.5% for those > or = 70. Among patients with G1 cancer differentiation 64.4% survived five years, with G2 39.1% and with G3 24.9%, respectively. CONCLUSION: Univariate analysis revealed a statistically significant, unfavorable impact of age > or = 70, with G3 cancer differentiation, clinically confirmed inguinal lymph node involvement and TNM classification stage on 5-year overall survival. Cox multivariate analysis demonstrated that independent prognostic factors for 5-year survival were the age of the patient, clinical status of inguinal lymph nodes and TNM classification grade.
Asunto(s)
Carcinoma/cirugía , Neoplasias de la Vulva/cirugía , Anciano , Carcinoma/patología , Carcinoma/radioterapia , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Estimación de Kaplan-Meier , Metástasis Linfática/patología , Estadificación de Neoplasias , Polonia , Modelos de Riesgos Proporcionales , Radioterapia Adyuvante , Factores de Riesgo , Resultado del Tratamiento , Neoplasias de la Vulva/patología , Neoplasias de la Vulva/radioterapiaRESUMEN
Nitroglycerine (NTG) is still the most important angina relief drug. The aim of the study was to evaluate clinical effects and tolerance of sublingually nitroglycerine sub form Nitromint-spray in patients with exercise induced angina pectoris (AP) using treadmill electrocardiography stress test (EST). The study group consisted of 40 adults patients (mean age 57.4 +/- 10.08 years) hospitalised in our clinic with AP confirmed by clinically and electrocardiographically positive EST. Tests were performed using treadmill Marquette-Centra equipment, according to the modified Bruce protocol after 3 days wash-out period. On the fourth day two ESTs were performed: EST-0 and 30 minutes later EST-NTG after sublingual administration 0.8 mg of NTG. Among measured parameters after NTG exercise induced ST segment depression decline from 2.3 +/- 1.0 to 1.5 +/- 0.8 (p < 0.0001). EST after NTG became electrocardiographically negative in 11 patients. NTG increased workload, and time to angina pain oneset (p < 0.0001). Nitromint-spray proved to be clinically effective, well tolerated and easy to use.