Scalene node excision biopsy in advanced prostate carcinoma

Scalene lymph node sampling in cervical carcinoma: a reappraisal

Scalene lymph node sampling to detect occult metastases from cervical carcinoma has been reported to have varying degrees of clinical utility. During the past 7 years at the Los Angeles County University of Southern California Medical Center, 17 scalene lymph node samplings were performed in patients with clinical stage IB to IIIB cervical carcinoma who had metastases to the paraaortic lymph nodes, negative chest X ray, and no clinical evidence of scalene/supraclavicular node metastases. Four of the patients were demonstrated on microscopic examination to have scalene lymph node metastases (23.5%). There were no serious complications related to this surgery. Patients with cervical carcinoma whose only extra pelvic site of metastases is the paraaortic modes should be considered for scalene lymph node sampling as part of their pretreatment evaluation, especially if extended-field radiation is contemplated.

A critical analysis of response criteria in patients with prostatic cancer treated with cis-diamminedichloride platinum II

Cis-diamminedichloride platinum II (DDP), 50--70 mg/m2 iv, q 3w was administered to 25 patients with Stage D adenocarcinoma of the prostate. Since the assessment of tumor regression in a disease-oriented phase II study demands a clear end-point of response, case selection was restricted to patients who had objectively measurable lesions, i.e., nodes, skin, lung, and liver metastasis. Partial remission occurred in 3 (12%) and stabilization of disease in 1 patient. Responders lived 53 weeks vs. 20 weeks for non-responders. In the dosage and schedule used in this protocol, DDP was not an active agent in the treatment of prostatic cancer. Various patient characteristics are examined and correlations made between remission rates and survival in this study vs. 4 other response schemata. A critical analysis of patient selection, "lead time" -- diagnosis to chemotherapy, and the definitions of the terms "measurable" lesions, "evaluable" parameters, "objective response", stabilization of disease and response criteria employed in the 4 schemata are also discussed.

Diagnostic scalene node biopsy in the preoperative evaluation of the surgical cancer patient: Five-year experience with 108 cases and literature review

Records were reviewed of 108 consecutive patients with a variety of surgically approachable malignancies undergoing scalene node biopsy as part of a preoperative staging evaluation. Metastases to the scalene nodes were detected in 12 patients (11.1%). In six patients the scalene nodes were clinically suspicious before biopsy, but in six with nonpalpable nodes the scalene metastases were occult clinically. Four of the patients with clinically benign, but pathologically positive, scalene biopsies were found among the group of 62 patients with epidermoid carcinoma of the cervix. It was concluded that routine scalene biopsies are justified in the properative evaluation of cancer patients only if the nodes are clinically suspicious, except for in patients with advanced pelvic cancers, in whom the incidence of completely occult scalene metastases is 6% or more.