The clinical records were reviewed of 1034 patients who had invasive carcinomas of the breast treated with radical mastectomy at Ellis Fischel State Cancer Hospital‐Cancer Research Center between 1940 and 1965. There was a correspondence between the size of tumors and both the frequency of axillary nodal involvement and patient survival. Although patients with nodal involvement had lower survival rates than those without, small tumor size was associated with a relatively favorable prognosis within each nodal category. These findings tend to support the value of early diagnosis of breast cancer.

No abstract

The clinical records and treatment results of 163 patients with Hodgkin's disease, who were seen at Ellis Fischel State Cancer Hospital (EFSCH) between 1940 and 1971, were reviewed and analyzed. More than 200 clinical and histological variables were recorded for each case of Hodgkin's disease, including details of radiotherapy and chemotherapy. Statistical studies were carried out in order to evaluate the independent prognosis significance of each of these factors. All of the lesions were reclassified according to the Lukes proposal which was modified and recommended at the 1965 Rye classification (except for hepatomegaly which was included in Stage IV). This is a retrospective study, and the modern techniques of staging were rarely used in pretreatment studies (since 1965, only ten patients have had an abdominal exploration). The basic work-up consisted of a complete blood count, urinalysis, blood type, chest X ray, and EKG. Lymphangiogram and radioisotope liver scans were used on less than 10% of the patients. About 30% of the patients had gastrointestinal X rays and 70% had IVP. Bone marrow biopsies -- the majority of which were done by needle aspiration -- were obtained for approximatley 50% of the patients. Clinical stage, histological type, and presence of absence of systemic symptoms appeared to be themost significant prognostic factors. The classification of systemic symptoms according to the criteria of either the Rye or Ann Arbor conferences showed no particular difference in determining the survival rate. Among the systemic symptoms, fever appeared to be the most important for survival rate. Survival rates were higher in nonanemic and nonlymphocytopenic patients. Eosinophilia, blood group, and Rh factor had no prognostic significance. The relapse-free interval was an important indicator of long-term prognosis. The unfavorable influence of relapse in ultimate prognosis was clearly seen; however, the extent of the relapse site was shown to have no significant influence on survival.

No abstract

This is a retrospective and all‐inclusive study of 527 patients with malignant lymphoma. A total of 178 major surgical procedures were carried out on 139 patients (an incidence rate of 18.4% for the 163 patients with Hodgkin's disease and 29.9% for the 364 with other lymphomas). There were 101 procedures done initially for diagnosis and 77 carried out after the diagnosis was established. Only 15 patients had laparotomies for staging purposes. The other operations included 59 celiotomies for diagnosis (21 had resection of organs), 42 abdominal operations for complications (malignant or nonmalignant), 11 radical node dissections, 6 radical mastectomies, 5 laminectomies, 4 thoracotomies, 3 bone operations, and 33 various other procedures. With the wider application of the exploratory laparotomy for staging and the improved survival with radiotherapy and chemotherapy, it is obvious that the future role of surgery will be quite different from the past. However, certain patients will still require major surgery for diagnosis. In addition, second cancers, conditions unrelated to lymphoma, complications secondary to aggressive therapy all may need surgical management.