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129 patients with carcinoma of the vulva were treated at the Dept. of Obstetrics and Gynaecology from 1966-1985. FIGO stage I was observed in 21% of the cases, FIGO stage II in 50%, FIGO stage III in 10% and FIGO stage IV in 8% of the patients. In 10% of the patients, definite classification was not possible. Mean age at the onset of the disease was 66.2 years, the mean time of observation 63 months. Kraurosis of the vulva or leukoplakia were simultaneous phenomena recorded locally in 67% of the patients. Histological investigation showed squamous cell carcinoma in 93% of the cases. The tumours were most frequently observed on the labia and the clitoris. 98% of the patients underwent surgery, 64% radical vulvectomy with inguinal lymph node disection. 56% of the patients of this group had a 5-year survival rate, which was 47% for the entire group of patients. Wound healing disorders were the most frequently observed postoperative complications. Metastasis to the inguinal lymph nodes at the time of diagnosis is the critical point of the prognosis. In the absence of lymph node involvement, 68% of the patients achieved a 5-year survival, in the presence of lymph node involvement, the 5-year survival rate was only 13%. Results obtained by this study support the view, that radical surgery at the earliest possible time is the treatment of choice for carcinoma of the vulva.

Thrombocyte aggregation with normochromic anaemia occurred in a gravida III of 27 years of age with sonographically confirmed foetal hydrocephalus, after prostaglandin E2 cervical priming. The authors discuss the differential diagnostic possibilities, but the actual genesis of the changes remains unclear. Hence, it is recommended to check with particular care especially in induction of abortion, the coagulation system with the thrombocytes, over and above the well-known prostaglandin side effects. Special attention must be paid to the occurrence of allergic reactions, and it must always be borne in mind that induction of abortion after the 14th week of gestation is a risky matter (1).

In-vitro sensitivity to cytostatics was tested in 281 carcinomas of the breast using the test method introduced by Volm. The Adriamycin 3H-uridine test system was chosen for the analysis. Altogether, 84.7% of the tumors were testable. A correlation with the subsequent in-vivo result was found in 219 of the breast cancer patients. Only 8% of the breast cancers were unequivocally sensitive to the test (uridine incorporation rate less than 55% for verification). The mean uridine incorporation rate was 577 CPM. Neither tumor size, lymph node status, nor the estrogen and progesterone receptor content of the tumor cells influenced the test result. With regard to the breast carcinoma, no relationship was found between the predictive information and the subsequent in-vivo response to chemotherapy. This applied to both short-term observation periods of three to six months as well as longer-term follow-ups. Furthermore, no connection was found between sensitivity in vitro and probability of recurrence (p = 0.69) under cytostasis. Probability of survival was higher among patients with tumors that were not sensitive to the test than among those with tumors which were (p less than or equal to 0.001). In the authors' experience the Volm chemosensitivity test only appears to furnish prognostic information about the breast carcinoma; in the light of their data the test appears rather unsuitable as an aid to deciding whether or not to institute cytostatic therapy.