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This article reviews the serial bone scans of 149 of 327 patients entered into a randomized prospective trial comparing orchidectomy versus zoladex and flutamide in patients with metastatic prostatic cancer. Attention is drawn to the difficulty of evaluating the response rate and of the importance of tumor load in determining survival. The use of sequential bone scans once the diagnosis of metastatic disease has been confirmed is of questionable value as the scans are expensive and contribute little to the further management of the patient in the absence of symptoms requiring relief.

One hundred and nineteen patients with gastrointestinal (GI) malignancy (80 colorectal, 25 gastric and 14 pancreatic carcinoma) were studied for rheumatoid factors (RF), antinuclear antibodies (ANA) and immunoglobulin levels and the findings correlated with size of tumor, stage of disease and survival. Twenty three (19.3%) of the patients were RF seropositive compared to 5.7% of 70 matched controls (P = 0.02). In two thirds of the seropositive patients RF were detected prior to the initiation of treatment. The proportion of RF seropositivity increased significantly in patients with tumors larger than 4 cm and in patients with Stage D disease. The authors found a high incidence of ANA in the patients: 32.4% compared to 8% in normal subjects (P < 0.01), but the proportion of RF in this group was not significantly different. Survival distributions of the RF positive cases were different from that of the other patients (18 versus 25 months median survival); however, this was not statistically significant. These findings indicate that RF in GI cancer patients sera is not rare and can be related mainly to “tumor load,” although not considerably affecting survival. Cancer 52:2156-2161, 1983.

Of 35 patients with metastatic ocular melanoma, 71.4% manifested liver involvement either initially (45.7%) or later in the course of the disease (25.7%). With liver involvement, the median survival was 2.2 months, whereas with pulmonary involvement it was 19.2 months after the first evidence of metastatic disease (P < 0.01). Survival after recurrence varied also with age, those younger than 50 years having median survival of 14 months, with those 50 years or older having median survival 3.5 months (P < 0.01). It also varied with the patient's sex, males having median survival 3 months after recurrence, and females 10.4 months (P < 0.05). Younger patients and females had also longer disease-free intervals prior to recurrence. Surgical removal of metastases, when feasible, in combination with chemotherapy, seems to offer improved palliation, since a subsequent median survival thus of 18.4 months was observed with 3/15 patients alive disease-free 1 to 3 years later, while the median survival of 20 patients not treated with surgery was 2.5 months. Most of this difference in survival, however, is due to a difference in tumor load between the two groups, with patients subjected to surgery having lesser amounts of tumor and/or more favorable sites. Cancer 52:334-336, 1983.