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Introduction: Phyllodes tumor of the breast (PTB) constitutes 0.2-2% of all breast tumors. The optimal extent of surgical excision (breast conserving surgery or mastectomy) is a matter of debate, especially for cases of borderline and malignant PTBs. From 1995 breast conserving surgery (BCS) is the treatment of choice in all patients with PTB in Cancer Center and Institute of Oncology in Krakow. The purpose of this study is to present experience with BCT patients with PTB at a single institution in Poland. Materials and Methods: Between January 1995 and December 2011, 101 women with PTB were primarily treated surgically at this center. Of these 101 patients, 87 (86.1%) underwent BCS and in 14 (13.9%) patients the mastectomy was performed. This study focused on a group of 87 patients treated with BCS. In 87 patients resection margins were negative. In 82 patients (94.3%) the surgical margin width ranged between 1-2 cm, but in five (5.7%) cases (three malignant and two borderline) it was less than 1 cm (range 0.2-0.9 mm). Those five patients were postoperatively irradiated. Results: In all 87 patients with PTB who were treated with BCS, 83 (95.4%) patients survived five years with no evidence of disease. Two patients (one benign PTB and one borderline PTB) died due to myocardial infarction. In the presented group during five-year follow-up, only two (2.3%) patients died because of malignant PTB (with lung metastases). None of patients developed a local recurrence. Conclusion: The treatment of choice for patients with PTB is BCS . If surgical margin is < 1 cm, adjuvant radiotherapy should be considered. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper was to present the clinical picture and the effectiveness of treatment patients with atypical medullary breast carcinoma (A-MBC). Materials and Methods: Sixty-five patients with A-MBC were treated between 1975 and 2005. More of them (70.2%) were in Stage I or II and had no expression of c-erb-B2 gene (81.5%), estrogen receptor (87.7%), and progesterone receptor (76.9%). Radical mastectomy was applied in 55 patients (84.6%) and remaining ten (15.4%) patients underwent breast conserving therapy. The treatment effectiveness was evaluated as ten-year disease-free survival (DFS) rate (Kaplan-Meier method). Results: The ten-year disease-free survival (DFS) rate was 61.5%. Only lymph nodal status was statistically significant prognostic factor. Ten--year DFS rate was 82.1% and 30.8% for pN0 and pN+, respectively. Conclusion: Although A-MBC has probably a slightly better prognosis than invasive ductal breast carcinoma, these patients should be treated according to the same rules as those with breast cancer of basal-like or triple-negative type. [ABSTRACT FROM AUTHOR]

Aim of the study: The analysis of acute and late toxicity of concurrent chemoradiotherapy (CCRT) for locally advanced cervical cancer (LACC) based on review of 120 patients treated in Centre of Oncology in Krakow between 2001 and 2007. Materials and Methods: Medium age of the patients was 52 years (43-66). Overall, 12 patients (10.0%) were in Stage IB2, 54 (45.0%) in Stage II, 43 (35.8%) in Stage III, and 11 (9.2%) in Stage IVA. Squamous cell carcinoma was present in 114 (95.0%) patients. Well-differentiated (grade 1) tumour was found in 39 (32.5%) patients, moderately differentiated (grade 2) in 41 (34.2%), and poorly differentiated (grade 3) in 40 (33.3%). Karnofsky performance status score was 70 in 72 (60.0%) patients, and 80-90 in 48 (40%). External radiation therapy was delivered with high-energy six to 15 MV photon beams using four-field brick technique. The total dose of 50 Gy was given in 25 fractions within five weeks using standard fractionation. Concurrently with external radiotherapy, six cycles of chemotherapy were administered to all the patients as an intravenous infusion of once-weekly cisplatin 40 mg/m². On completion of external beam radiotherapy, low-dose rate brachytherapy with tandem and two colpostats was performed to deliver the dose of 40 Gy to point A in two 20 Gy insertions at weekly intervals. Results: Of the 120 patients in the investigated group, 78 (65%) were disease-free for five years. Symptoms of acute treatment-related toxicity grade 3 or 4 (WHO) occurred in 21.6% of patients including leucopoenia in 7.5%, anaemia in 5.0%, nausea and vomiting in 3.3%, diarrhea in 5.0%, and urinary tract infection in 0.8%. Full planned treatment (teleradiotherapy + chemotherapy + brachytherapy) completed 78.3% of the group; full planned radiotherapy without full chemotherapy completed 20% of the patients. Late treatment complications of grade 3 or 4 were observed in two (1.6%) patients (narrowing of large intestine requiring surgery and recto-vaginal fistula). Conclusions: In patients with LACC treated with CCRT, the most frequent acute toxic effects include: haematological disorders (leucopoenia, anaemia), gastrointestinal disorders (nausea and vomiting, diarrhea), vulvo-vaginal disorders, and urinary tract infection. The most frequent late toxic effects included: rectal bleeding, bowel complications requiring surgery, stenosis or recto-vaginal fistula, and haematuria. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study was to present an institutional experience in radiation therapy of primary invasive vaginal carcinoma (PIVC) patients treated in the Krakow Branch of Centre of Oncology, with special regard to treatment effectiveness and failure causes. Materials and Methods: Between February 1967 and January 2007,162 PIVC patients were treated with radical radiotherapy in the Krakow Branch of Centre of Oncology, Maria Sklodowska-Curie Memorial Institute. Twenty-seven (16.7%) patients in Stage 1° were treated with intracavitary brachytherapy alone; for 127 (78.4%) patients in Stage 1° - IV0 intracavitary brachytherapy was combined with external radiation therapy; and eight (4.9%) patients in Stage IVA0 were given only external radiotherapy. Results: In the investigated group of 162 patients, five-year disease-free survival was observed in 46.3% of the cases. Patient age and FIGO Stage of neoplastic disease were independent prognostic factors. Five-year disease-free survival was observed in 64.9% of the patients < 60 years of age and only in 30.7% > 60 years of age; and in 62.3% of PIVC patients in Stages I and II0 as compared to 19.7% of Stages III0 and IV0 cases. Among 78 patients who died of PIVC, in 60 (76.9%) cases the cause of death was locoregional failure; in six (7.7%), locoregional failure and distant metastasis; and in 12 (15.4%), distant metastasis. Conclusions: Radiotherapy is effective treatment for PIVC patients. Age below 60 years and non-advanced neoplastic disease were independent favourable prognostic factors in the investigated group of patients. The primary cause of treatment failure was failure to achieve locoregional disease control. [ABSTRACT FROM AUTHOR]

Introduction: Invasive lobular carcinoma (ILC) comprises 4-15% of all malignant neoplasms of the breast. The "classical variant of ILC" (C-ILC) constitutes some 60-80% of this cancer. The main cause of treatment failures is dissemination observed in 8-38% patients The disant metastases (DM) are frequently localized in: bones, gastrointestinal tract, uterus, leptomeninges, and ovaries. The aim of this study was to present the methods and results of the treatment of patients with DM from the classical variant of ILC (C-ILC) at a single institution in Poland., Materials and Methods: Between January 1983 and December 2004, 210 women with C-ILC of the breast were primarily treated surgically (mastectomy in 182 (86.7%) patients and breast conserving therapy in 28 (13.3%) patients). Then adjuvant therapy (radiotherapy, chemotherapy, and hormonotherapy) was applied according to presence of clinical indications., Results: The present study focused on a group of 41 patients with a median age of 59 that died with DM from C-ILC during the ten-year follow-up. This failure developed on average 65 months (3-186) after surgery of ILC. The most frequently DM developed: bones (39.1%), GI (small bowell, stomach, colon, rectum) - 31.8%, and reproductive organs (ovary, uterus) - 19.1%. In therapy of DM, different configuration surgery, radiotherapy, and chemo-hormonotherapy were used. The median survival after the diagnosis of DM was connected with localization of distant metastases., Conclusion: Patients with classic variant of infiltrate lobular cancer of breast should be regularly follow-up, which could permit early diagnosis of distant metastases and improve treatment results.

Between 1970 and 1991, 22 patients with pure immature teratoma were treated at the Center of Oncology in Krakow. Sixteen (72.7%) patients had stage I, four (18.2%) stage II, and two (9.1%) stage III of disease, nine (40.9%) patients had grade 1, 11 (50%) grade 2, and two (9.1%) grade 3 tumors. Eight stage Ia, grade 1 patients were treated with surgery only, the remaining 14 (63.6%) received postoperative chemotherapy. Five-year NED (no evidence of disease) survival was achieved in 81.8% of patients. Out of 16 stage I patients, 15 (93.8%) survived 5-year NED, out of six stage II and III, three (50%) patients only survived this period. We cured all grade 1 patients, and 81.8% (9/11) grade 2; two grade 3 patients died because of tumors. We also cured all six stage Ia patients, treated with unilateral salpingo-oophorectomy (with or without chemotherapy), and all eight stage Ia grade 1 patients treated with surgery only.