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About 70,000 malignant primary tumors with skeleton metastases are regarded with respect to tumor age, survival time with metastases respectively with primary tumor and life expectancy. Some cases with mamma carcinoma showed the vertebral type of bone metastasizing whereas the other primary tumors showed the typical type of spreading metastases over the lung. Patients with skeleton metastases are younger than the others. They have a longer survival time than the other patients without bone metastases but they die earlier. In those cases in which the primary tumor was diagnosed because of bone metastases without any earlier tumor treatment the survival time with metastases was longer than in other patients. Metastases with low grade histological differentiation were more often to be seen in patients who got their primary tumor in younger age. These metastases arose in a relatively late stage of the disease.

Gliome: Wir konnten zeigen, das fur ubliche supratentorielle Gliome im Erwachsenenalter ein 2stufiger Grading-Ansatz mit alleiniger Unterscheidung eines niedrigen und hohen Malignitatsgrads zu reproduzierbaren und prognostisch relevanten Informationen fuhrt. Das entscheidende diagnostische Kriterium sowohl fur High-grade-Astrozytome (WHO Glioblastome) als auch fur anaplastische Oligodendrogliome und Oligoastroazytome sind Endothelhyperplasien bzw. -proliferate als Zeichen einer in Gang gekommenen Neoangiogenese. Diese ist in der Regel mit einer Kontrastmittelaufnahme in den bildgebenden Verfahren korreliert. Daher hat es sich sehr bewahrt, wenn zur histopathologischen Untersuchung eines Gliomresektats bzw. -biopsats die neuroradiologischen Bilder (CCT, KST nativ und nach Kontrastmittelgabe) vorliegen oder zumindest das neuroradiologische Untersuchungsergebnis bekannt ist. Meningeome: Jene rezidivgefahrdeten Meningeome, die sowohl feingeweblich als auch prognostisch eine Zwischenstellung zwischen ublichen und anaplastischen Meningeomen einnehmen, sind als sog. atypische Meningeome (WHO-Grad II) in die revidierte Fassung der WHO Klassifikation aufgenommen worden. Mit morphometrisch ermittelten kernflachenbezogenen Ki-67 Indizes konnte dieser intermediare Typ naher eingegrenzt und histologisch besser definiert werden. Da rezidivgefahrdete Meningeome als haufigste progressionsassoziierte Veranderung einen distalen Stuckverlust am kurzen Arm eines Chromosoms 1 (1p-) zeigen, lies sich eine Screening-Methode mit der gewebeunspezifischen Form der Alkalischen Phosphatase als Markerenzym etablieren. Die Diagnose eines Meningeoms vom intermediaren Typ bedeutet, das engmaschigere postoperative Verlaufskontrollen zur fruhzeitigen Erfassung eines „Rezidivs” erfolgen sollten.

Die histologische Bestimmung des Anaplasiegrades von Gliomen wird nach qualitativen histologischen Merkmalen (Kernpleomorphie, Mitosen, Endothelproliferate, Tumornekrosen) vorgenommen und mit dem Malignitatsgrad gleichgesetzt. Vor allem die Wichtung dieser Merkmale (”gering – mittel – stark ausgepragt”) unterliegt dem subjektiven Eindruck des jeweiligen Befunders. Um eine hohere Reproduzierbarkeit der Gradingbeurteilung zu erreichen, wurde auf die Wichtung verzichtet und lediglich das Vorhandensein oder Fehlen dieser vier definierten qualitativen Kriterien verzeichnet. Es hat sich gezeigt, das durch dieses binare System eine verlaslichere Aussage uber die Dignitat von Gliomen moglich ist (Ste. Anne-Mayo-System, SAMS). Neuere Untersuchungen belegen, das auch fur das Grading der Oligodendrogliome und der Mischgliome ein ahnliches binares System praktikabel ist, wobei sowohl fur die Astrozytome als auch fur die Oligodendrogliome die Unterscheidung einer niedrigen und hohen Risikogruppe uber das Fehlen oder Vorhandensein von Endothelproliferaten durchgefuhrt wird. Die Endothelproliferate ihrerseits – als Zeichen einer in Gang gekommenen Tumorangiogenese – korrelieren mit der Kontrastmittelanreicherung bei der kranialen Computer- und Kernspintomographie.

Meningiomas account for the most frequent primary intracranial neoplasms in adults. In 1993, the so-called atypical meningioma has additionally been introduced in the revised edition of the WHO Classification of Tumors of the Central Nervous System and should characterize meningiomas with an increased propensity to recur. Since the given qualitative histological criteria apply both to the "atypical" and anaplastic meningioma, mere histological grading appears somewhat critical. Therefore, additional parameters were tested for their contribution to meningioma grading: First of all, we succeeded in defining 3 meningioma "grades" by calculating corresponding 95% confidence intervals for the morphometrically assessed Ki-67 indices of 160 meningiomas in total, the validity of which was proved by comparison with the "recurrence"-free intervals. Histologically, atypical meningiomas were distinguished by a "syncytial", poorly structured growth pattern and macronucleoli. Only occasionally, nuclear pleomorphism, necroses and mitotic figures were found. Cytogenetics revealed, in 50% of the "atypical" and anaplastic meningiomas, partial loss of the short arm of one chromosome 1 (1p-). Histochemically, we could demonstrate, that the tissue non-specific type of alkaline phosphatase (ALPL), which is coded on chromosome 1p, is a convenient recurrence- and progression-associated marker enzyme for meningiomas with 1p-loss (loss of enzyme activity in 30/39 of intermediate and 8/8 anaplastic meningiomas). We favor to address the WHO "atypical" meningioma as meningioma of the intermediate type, since the attribute "atypical" in the context of histological diagnoses is highly susceptible to misinterpretations.

Die Gruppe der dysembryoplastischen neuroepithelialen Tumore (DNT) wurde erstmals von Daumas-Duport et al. 1988 beschrieben und 1993 als eigenstandige Tumorentitat in die revidierte Fassung der WHO der Klassifikation der Hirntumoren aufgenommen. Ziel der vorliegenden Arbeit ist, die neuroradiologischen CT- und MRT-Charakteristika von DNT aufzuarbeiten. Funf Patienten im Alter von 11–61 Jahren (3 Frauen, 2 Manner) wurden prachirurgisch neuroradiologisch untersucht (5 CT-, 4 MRT- und 2 DSA-Studien). Klinisch litten 4 Patienten unter epileptischen Anfallen und 1 Patientin unter okzipital betonten Kopfschmerzen. In 2 Fallen wurde der Tumor mikrochirurgisch komplett und in 2 Fallen nach vorausgegangener stereotaktischer Biopsie partiell reseziert. Bei 1 Fall wurde nur eine stereotaktische Biopsie durchgefuhrt. Alle DNT waren kortikal lokalisiert: 2 frontobasal medial im Gyrus rectus, 2 temporobasal im Gyrus occipitotemporalis lateralis und einer infratentoriell im Lobus caudalis cerebelli. Sie liesen sich scharf vom umgebenden Hirngewebe abgrenzen und zeigten im MRT einen multinodularen Tumoraufbau. Die kortikale Lokalisation lies sich am besten im MRT erkennen, insbesondere auf koronaren und sagittalen Schnitten. Im CT stellten sie sich als hypodense Lasion dar. Im MRT zeigten sie T2-gewichtet eine Signalerhohung, T1-gewichtet ein erniedrigtes Signal und in der Protonenwichtung einen hyperintensen Rand mit kleinen, geringgradig hyperintensen Zysten. Zwei DNT nahmen Kontrastmittel auf, wahrend bei 3 keine Kontrastmittelaffinitat nachweisbar war. Der infratentorielle DNT lag in unmittelbarer Nachbarschaft zu einem Defekt der Tabula interna, in welchen er sich ausdehnte. Die 2 angiographisch untersuchten DNT zeigten keine Tumorneovaskularisation. Ein umschriebener, im CT hypodenser, scharf begrenzter Tumor mit einer multinodularen Struktur im MRT, kortikal lokalisiert, ohne Raumforderungszeichen, verbunden mit der klinischen Symptomatik einer Epilepsie ist stets verdachtig auf das Vorliegen eines DNT. Wie unsere Ergebnisse zeigen, konnen DNT auch infratentoriell auftreten.

We present a CLIPPER program for the calculation and graphical representation of minimal spanning trees (MST) which is available on request on diskette from the authors. The MST are a useful parameter for structural cluster detection. They can be applied to grading problems in tumour biology. We present and discuss the applicability of MST by an example from the field of astrocytoma grading.

In this note we present a combined Ki-67 and Feulgen stain for morphometric determination of the Ki-67 labelling index. The immunohistochemical part of this double staining technique is based on the alkaline-phosphatase-anti-alkaline-phosphatase (APAAP) method, visualizing the enzyme activity by the nitro-blue-tetrazolium chloride (NBT)/bromo-chloro-3-indolyl-phosphate (BCIP) technique. The NBT/BCIP complex resists the hydrolytic activity of the Feulgen stain. The staining method presented allows semi-automatic determination of both the total nucleus-area as well as the Ki-67 positive nucleus-area using a morphometric computer system. The Ki-67 labelling index thus achieved is based on the relative nuclear area of Ki-67 positive nuclei and is clearly more precise and efficient than the counting method using an ocular grid.

Summary We present an electronic primer in dermatopathology based on a full-text retrieval system which contains all the features of traditional handbooks of dermatopathology. The system including high-resolution black and white pictures with coloured overlays runs on every personal computer with VGA card and needs no additional software and hardware equipment. The representation of pictures is improved by using high-resolution VGA cards. The system is able to work like an electronic diagnostic consultant in dermatopathology.

GLIOMAS: As we demonstrated for supratentorial, diffuse gliomas in adults, a stratification into just two grades of malignancy, 'low' and 'high grade,' proved reliable and prognostically relevant. The discriminating histomorphological criterion for high-grade astrocytoma (WHO glioblastoma) as well as anaplastic oligodendroglioma and anaplastic oligoastrocytoma is endothelial hyperplasia/proliferation, which is usually associated with uptake of contrast medium in computed tomography and magnetic resonance imaging. As neoangiogenesis indicates glioma progression, it is worthwhile considering these radiographic features to judge the representativeness of the tumor samples critically. MENINGIOMAS: The revised edition of the WHO classification of brain tumors now includes the 'atypical' meningioma (WHO 'grade' II): Based on both its histomorphological features and prognosis, it should be placed between the common type and anaplastic meningioma. Nuclear area related Ki-67 proliferation indices, as determined by morphometry, were the prerequisite for outlining its histomorphological spectrum better. Cytogenetically, the most consistent progression-associated feature was loss of the distal part of the short arm of one chromosome 1 (1p-). Thus, a screening method using the tissue non-specific form of alkaline phosphatase (ALPL) as the respective marker enzyme was established. Diagnosing a meningioma of the intermediate type implies careful clinical and radiological patient follow-ups to detect tumor recurrences early.

The histologic determination of the degree of tissue anaplasia and grade of malignancy of gliomas is based upon qualitative histological features (nuclear pleomorphism, mitoses, endothelial proliferation, tumor necrosis). This grading approach is influenced by the subjective interpretation of the pathologist, especially concerning the weighting of criteria (scant, moderate, pronounced). An observer-independent approach seems to be feasible by abandoning the concept of parameter weighting in favor of an binary approach noting only the presence or absence of these structure parameters. This grading procedure is recognized in the revised WHO classification of brain tumors for common type astrocytomas (Ste. Anne-Mayo System, SAMS). Our results indicate that a similar approach is also suitable for grading purposes of oligodendrogliomas and mixed gliomas. Our recent investigations on glioma grading showed, both for astrocytomas and oligodendrogliomas, that a two-tiered grading scheme distinguishing only "low-grade" and "high grade" cases was prognostically relevant. For all glioma entities the onset of tumor angiogenesis with endothelial proliferation and contrast enhancement in CT and MRI seems to be the key criterion indicating irreversible tumor progression to the "high" malignancy grade.

A grading system based upon morphometrically assessed quantitative parameters (HOM system) was correlated with the results of classical histologic grading (St. Anne/Mayo system [SAMS], 1988, and World Health Organization classification, 1993). Validation was done by comparison with survival data.This retrospective study consisted of representative paraffin-embedded tissue sections of 139 adults who had been surgically treated for supratentorial common gliomas between 1988 and 1994. Histologic grading diagnoses were adapted to the latest standard. Computer-assisted image analysis of Ki-67 (MIB1)/ Feulgen-stained sections provided nuclear parameters appropriate to define homogeneous grades of malignancy by multivariate statistical analyses: average segment length of the minimum spanning trees (ASLMST) for the quantitation of tumor growth pattern; nuclear area percentage (NAP), reflecting cellularity; and volume-weighted mean nuclear volumes (vV) for estimating nuclear size and pleomorphism.Analysis of survival data yielded no statistically significant differences between astrocytomas and oligoastroacytomas (Lee-Desu test, alpha = 5%). Furthermore, only two prognostically different grades could be established, "low grade" and "high grade" gliomas, with the first representing SAMS grades 2 and 3 and the latter SAMS grade 4 (alpha = .1%). The same applied to HOM grades (alpha = .1%). Cox regression analysis of survival data demonstrated that histologic grading diagnoses and NAP tallied best with patients' outcome.

This second part of our study of 'pure' oligodendrogliomas focuses on survival data analysis. In order to identify potentially useful prognostic factors and to assess the effectiveness of a new grading system, the 79 patients in the previously analyzed series for whom adequate follow-up could be obtained (52%) were entered in the present analysis. Statistical analysis demonstrated that contrast enhancement and endothelial hyperplasia had powerful and similar influence on survival. Median survival with and without contrast enhancement were: 3 versus 11 years, and with or without endothelial hyperplasia were: 3.5 versus 11 years. Conversely, the degree of nuclear atypia and presence or absence of mitosis or necrosis were not correlated with survival. These findings allowed us to devise a simple grading system which discriminates two malignancy grades as follows: absence of endothelial hyperplasia and of contrast enhancement = Grade A, presence of endothelial hyperplasia and/or of contrast enhancement = Grade B. Of the 79 oligodendrogliomas in this study, 59 tumors were categorized as grade A and 20 as grade B. Median survival were: 11 years in grade A and 3.5 years in grade B. Five-year and 8-year survival rates were: 89% and 60% in grade A and: 33% and 15% in grade B. Double blind grading between two independent observers was concordant in 96% of the cases. Application of this simple efficient and reproducible grading scheme should permit reliable comparison of retrospective or prospective therapeutic data emanating from various institutions.

The intermediate type meningioma (formerly "meningioma variant with signs of increased proliferation activity"; WHO "atypical" meningioma) represents a meningioma group the mean Ki-67 index and the recurrence rate of which lie between those of the ordinary and the anaplastic type [Kolles et al. 1995]. In the study cited (n = 160) the percentage of recurrences was 9% in the common, 29% in the intermediate, and 50% in the anaplastic type. The present study focuses on 49 subsequently diagnosed meningiomas of the intermediate type. Apart from certain histopathological features, the most important independent factors associated with recurrence were Ki-67 indices covering the 95% confidence interval between 3.7% and 4.9%. At the light-microscopic level, however, meningiomas in general, and especially those supposed to belong to the intermediate type, are highly variable in tissue architecture and do, in contrast to the anaplastic type, not display frank histological features of anaplasia. Morphologically, the growth pattern of solid ("syncytial") sheets, micronecroses, and large distinct nucleoli are suspicious. Cytogenetically, independent of the loss of one chromosome 22, it has been shown that terminal loss of the short arm of one chromosome 1 (1p-) or complete loss of this chromosome were useful additional indicators of meningioma progression.

Dysembryoplastic neuroepithelial tumors (DNT) were first described as a new tumor entity by Daumas-Duport et al. in 1988 and were introduced into the revised WHO classification of brain tumors in 1993. The purpose of this study was to work out neuroradiological CT and MRT patterns of DNT. Five patients, aged 11-61 years (three female, two male) underwent complete presurgical neuroradiological exploration (5 CT, 4 MRT investigations, 2 angiography) because of brain tumor. Four cases complained of seizures and one of occipital-located headache. Total microsurgical excision was achieved in two cases. Two further lesions were resected subtotally after stereotactic biopsy diagnosis. In one case, stereotactic biopsy alone was carried out. All DNTs were localized cortically: two frontobasal medial in the gyrus rectus, two temporobasal in the gyrus occipitotemporalis lateralis and one infratentorial in the lobus caudalis cerebelli. They were sharply demarcated from the surrounding brain tissue. Cortical localization was better visualized by MRT, especially on coronal and sagittal images. CT scans showed a hypodense lesion, MRT a high-signal intensity in T2, low signal in T1 and in proton-weighted images a hyperintense rim with a slightly hyperintense small cyst. The multinodular tumor architecture was best seen in MRT. Two DNTs presented partial contrast enhancement, while three DNTs did not take up contrast. In two lesions there were focal calcifications. The infratentorial DNT was associated with a bony defect of the tabula interna into which the tumor expanded. Two angiographies showed no pathological tumor neovascularization. A hypodense sharply demarcated lesion with a multinodular pattern in MRT with cortical location and without space-occupying signs is, in combination with the clinical symptom of epileptic seizures, highly suggestive of DNT. As our results demonstrate, DNT can also occur in the infratentorial space.

To compare four data-driven approaches to automated tumor grading based on morphometric data. Apart from the statistical procedure of linear discriminant analysis, three other approaches from the field of neural computing were evaluated.The numerical basis of this study was computed tomography-guided, stereotactically obtained astrocytoma biopsies from 86 patients colored with a combination of Feulgen and immunhistochemical Ki-67 (MIB1) staining. In these biopsies the cell nuclei in four consecutive fields of vision were evaluated morphometrically and the following parameters determined: relative nuclei area, secant lengths of the minimal spanning trees and relative volume-weighted mean nuclear volumes of the proliferating nuclei.Based on the analysis of these morphometric features, the multivariate-generated HOM grading system provides the highest correct grading rates (90%), whereas the two widely employed qualitative histologic grading systems for astrocytomas yield correct grading rates of about 60%. For automated tumor grading all approaches yield similar grading results; however, back-propagation networks provide reliable results only following an extensive training phase, which requires the use of a supercomputer. All other neurocomputing models can be run on simple UNIX workstations (ATT, U.S.A).In contrast to discriminant analysis, backpropagation and Kohonen networks, the newly developed neural network architecture model of self-editing nearest neighbor nets (SEN3) provides incremental learning; i.e., the training phase does not need to be restarted each time when there is further information to learn. Trained SEN3 networks can be considered ready-to-use knowledge bases and are appropriate to integrating further morphometric data in a dynamic process that enhances the diagnostic power of such a network.

We performed simultaneous fluorescence in situ hybridization (FISH) with centromere-specific DNA probes for chromosomes 7 and 10 and Ki-67 proliferation labelling on smear preparations of 17 differentiated and anaplastic human astrocytomas and glioblastomas. In 15 of the 17 cases studied, Ki-67-positive clones differed from Ki-67-negative clones mainly by the loss of one copy of chromosome 10, either combined with or independent of trisomy 7. The findings suggest that monosomy 10 is an earlier event than generally supposed in the development of human gliomas and that it is directly related to cellular hyper-proliferation.

The speech recognition system DragonDictate-30 K is the first commercially available product for personal computers (PC) that includes a thesaurus of 30,000 words which can replace the computer keyboard completely for report writing. The system is speaker-adaptative, i.e., it can learn the phonetic pattern of the pathologist's voice. We have developed a thesaurus with special terms from the field of diagnostic pathology to shorten the time-consuming training phase. DragonDictate is compatible with all text-oriented DOS computer software tools. The recommended minimal hardware configuration is a personal computer with a 80,486 processor with 16 MB on board and a 200 MB hard disk.

We report on a 53-year-old woman and her 20-year-old son who both presented with polysyndactyly, without other external malformations or mental retardation. MRI imaging revealed, as an incidental finding, asymptomatic hypothalamic hamartomas in both patients. The siblings of both mother and son are unaffected. This family may represent an autosomal dominant variant of Pallister-Hall syndrome.

We present a decision support system that processes lexical fuzzy knowledge from standard pathology textbooks. The user can choose among four methods: full text and hypertext approaches (classic lexical retrieval methods) and two possibilistic, knowledge-based approaches (the fuzzy logic computation and an adapted evidence combination scheme based upon the theory of belief functions). All these methods, including their algorithms, are presented in this paper. The effectiveness of these approaches is demonstrated by examples from dermatopathology. At the top of the lists of differential diagnoses generated by the system the degree of conformity between the approaches is high.

In a female patient, aged 47 years at the beginning, the successive appearance of extrapyramidal signs preceded by depression, paranoid-hallucinatory psychosis, autonomic and cerebellar dysfunction was followed up over a period of 8 years. Autopsy revealed--in accordance with the clinical symptomatology--both olivo-ponto-cerebellar atrophy and a striatonigral degeneration. As a rule these changes are accompanied by dementia. The reported case is unusual in having first presented with severe depression and paranoid-hallucinatory symptoms.

Weltweit existieren mehr als hundert Krebsregister. In der Bundesrepublik gibt es zur Zeit nur zwei bevolkerungsbezogene Krebsregister: Das Hamburgische Register und das Krebsregister des Saarlandes. Die Bevolkerung des Saarlandes von ca. 1.1 Mio. Einwohnern ist nach Sozialstruktur und Stadt-/Land-Verteilung als Stichprobe fur die Verhaltnisse in der Bundesrepublik geeignet.

We present a computer-assisted, diagnosis-finding system based on the simple stochastic approach of Bayes; this system was realized in a standard database architecture and run on DOS personal computers. The expert knowledge in the form of specified morphologic criteria was keyed in by means of pull-down menus or downloaded if the system was linked with a reporting system according to the dBASE (Ashton-Tate, Inc, Torrance, Calif) database standard. We present a simple example in dermatopathology but the system shell can also be used for applications in other fields of pathology. This article is not restricted to general remarks about computer-assisted diagnosis finding. The compiled program and the easily comprehensible and well-documented program listings in the CLIPPER (Nantucket Corp, Los Angeles, Calif) or DOS language is available on request.

Unter den onkologischen Erkrankungen gehoren die malignen Kindestumoren zu den vergleichsweise seiten auftretenden Tumorleiden. Dem Krebsregister des Statistischen Amies des Saarlandes wurden von 1980–1986 insgesamt 139 bosartige Tumoren bzw. Systemerkrankungen bei Patienten unter 16 Jahren gemeldet.

Based on data from the Saarland (W. Germany) Cancer Registry, epidemiology and prognosis of gynaecological malignancies is presented for the period 1971-1985. Breast cancer is the most frequent gynaecological tumour followed by tumours of the uterus (cervix + corpus). This is in accordance with worldwide observations. The age distribution of all analysed tumour localisations follows approximately a normal distribution with a maximum between 60 and 65 years of age. Tumours of the breast, cervix and corpus have almost the same prognosis (5-year-survival-rate greater than 60%); the prognosis of ovarian cancer is distinctly poorer. A clear decrease in the incidence is observed only for cervical cancer. The indications are that the proportion of aged patients is continually rising. The mortality, on the other hand, does not increase to the same extent, which indicates a progressive success of therapy of gynaecological malignancies. Since the Saarland Cancer Registry is the only population-based unit functioning for a sufficiently long period, the results represent a model of the situation in the Federal Republic of Germany.

Die Uberlebenszeitanalyse (survival analysis) hat in den letzten Jahren als biometrisches Verfahren zunehmend an Bedeutung gewonnen. Das gilt besonders fur die prognostische Beurteilung von Tumorerkrankungen; dazu ist die oft benutzte (und oft falsch berechnete) Grose „Funf-Jahres-Uberlebenszeit“ jedoch nur sehr schlecht geeignet. Die Uberlebenszeitanalyse verfugt uber zahlreiche differenzierte Verfahren, die auch in den bekannten Statistik-Programmpaketen (z.B. SAS, SPSS, BMDP) implementiert sind.

About 70,000 malignant primary tumors with skeleton metastases are regarded with respect to tumor age, survival time with metastases respectively with primary tumor and life expectancy. Some cases with mamma carcinoma showed the vertebral type of bone metastasizing whereas the other primary tumors showed the typical type of spreading metastases over the lung. Patients with skeleton metastases are younger than the others. They have a longer survival time than the other patients without bone metastases but they die earlier. In those cases in which the primary tumor was diagnosed because of bone metastases without any earlier tumor treatment the survival time with metastases was longer than in other patients. Metastases with low grade histological differentiation were more often to be seen in patients who got their primary tumor in younger age. These metastases arose in a relatively late stage of the disease.

The deficiency of life expectancy (DLE), calculated as the difference between the statistical life expectancy at a given age and the survival time with the tumor disease, is a useful measure to extend the concept of tumor malignancy. Both the evaluation of the success of the tumor treatment and the prognosis of the metastatic spread in the vertebral column can be determined with the DLE. For the 9 most frequent tumor localizations the DLE is calculated with the material of the register of cancer in the Saarland/W. Germany (N = 70,128). In an extra part, the DLE for 50 metastases of the spine is compared to the whole cases.

Weltweit sind betrachtliche Unterschiede in der Morbiditat und Mortalitat des Prostatacarcinoms bekannt. Die hochste Inzidenz besteht bei der schwarzen Bevolkerung in den USA, Asiaten hingegen erkranken nur sehr selten.

Based on data from the Saarland (W. Germany) Cancer Registry, epidemiology and prognosis of gynaecological malignancies is presented for the period 1971-1985. Breast cancer is the most frequent gynaecological tumour followed by tumours of the uterus (cervix + corpus). This is in accordance with worldwide observations. The age distribution of all analysed tumour localisations follows approximately a normal distribution with a maximum between 60 and 65 years of age. Tumours of the breast, cervix and corpus have almost the same prognosis (5-year-survival-rate greater than 60%); the prognosis of ovarian cancer is distinctly poorer. A clear decrease in the incidence is observed only for cervical cancer. The indications are that the proportion of aged patients is continually rising. The mortality, on the other hand, does not increase to the same extent, which indicates a progressive success of therapy of gynaecological malignancies. Since the Saarland Cancer Registry is the only population-based unit functioning for a sufficiently long period, the results represent a model of the situation in the Federal Republic of Germany.