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Objective: Pure epithelial breast metaplastic carcinoma is a rare and highly malignant tumor. In this study, our purpose was to analyze the clinical features, treatment method and prognostic factors, so to explore the approach for early diagnosis and appropriate treatment of this cancer., Methods: Clinical data of 22 patients with histopathologically confirmed pure epithelial breast metaplastic carcinoma and treated at Tianjin Cancer Hospital from 1974 to 2008, were reviewed retrospectively. Survival rate was calculated by life tables. Kaplan-Meier unvariate analysis and Log-rank test were used to compare the survival rates. Multivariate factors for survival were analyzed by Cox proportional hazards regression model., Results: The median age of the 22 cases of pure epithelial breast metaplastic carcinoma was 52.5 years. Among them 20 cases went to see a doctor for painless mass, and two cases shown as skin inflammation. Clarifying a diagnosis was difficult before operation so that its diagnosis mainly depended on postoperative histopathologic examination. Twelve cases had axillary lymph node metastasis, 7 cases distant metastasis, and the lung was the most common metastatic organ. The 5-year survival rate was 55.6%, with a median follow-up of 46 months. It was found by Kaplan-Meier unvariate analysis that the age (P = 0.044), number of positive axillary lymph nodes (P = 0.011) and therapeutic schedule (P = 0,003) significantly influenced the outcome of the patients, but tumor size (P = 0.194) was not. Cox multivariate analysis results showed that number of positive axillary lymph nodes was independent prognostic factor for pure epithelial breast metaplastic carcinoma (P = 0.038)., Conclusions: Pure epithelial breast metaplastic carcinoma is seldom seen. It is easy to cause distant metastasis and has a poor prognosis. ER, PR and HER-2 expressions in most samples are negative. The more axillary lymph nodes have metastasis, the poorer is the prognosis. A reasonable and comprehensive treatment can improve the prognosis obviously.

Background & Objective: Elderly women with cervical carcinoma have the features of poor prognosis and high incidence rate of complications. This study was designed to evaluate the prognostic impact of surgery versus radiotherapy in old women with stage I and stage II cervical carcinoma and seek suitable treatment for such patients., Methods: Clinical data of 179 elderly women with stage Ia to stage IIb cervical cancer were analyzed retrospectively. One hundred and thirty-four cases underwent radical hysterectomy also received appropriate adjuvant radiotherapy and/or chemotherapy. Forty-five cases underwent radiation therapy received appropriate adjuvant chemotherapy., Results: The 5-year survival rates of patients underwent surgery and radiotherapy were 78.32% and 49.08% (P = 0.04), respectively. The incidence rate of complications of patients receiving surgery was 47.01% (63/134). Three patients died of complications after radical hysterectomy. The incidence rate of complications of patients underwent radiotherapy was 75.63% (34/45)., Conclusion: Geriatric patients with stage I and stage II cervical carcinoma should receive operation if possible and should receive adjuvant treatments according to personal conditions.

Objective: To study the clinical biocharacteristics of primary esophageal adenocarcinoma (PEAC) and factors influencing patients' prognosis and to find reasonable surgical indications and combined therapy., Methods: To analyse the clinical materials of 106 patients with PEAC undergone operation compared with those of patients with esophageal squamous-cell carcinoma (ESCC)., Results: The overall resectability, morbidity and 30-day mortality rate of PEAC was 92.5%, 23.5% and 2.8% respectively, similar to those of ESCC. The TNM staging, lymph node metastasis, extraesophageal invasion and types of operation were the major determinants influencing long-term prognosis. The 5-year survival rate of PEAC was 21.0%, which was lower than that of ESCC(P < 0.01). Metastasis or recurrence remained to be the cause of death in 82.4% of patients who lived longer than 5 years, which was higher than that of ESCC(P < 0.01). Adjuvant radiation did not influence survival of the patients with lymph node metastasis, but appeared helpful to the patients with no lymph node metastasis., Conclusion: Compared with ESCC, PEAC is a malignent disease with poor prognosis. Surgical resection is the first and chief choice of treatment. Surgical indications include patients in stage 0, I, II and some in stage III and even in stage IV of PEAC. Early diagnosis and early treatment as well as curative operation could improve prognosis. Adjuvant radiation therapy appeares helpful only to the patients without lymph node metastasis.