Cervical carcinoma: treatment results and complications of extended- field irradiation

The authors studied treatment complications, recurrence patterns, and survival in 18 patients with histologically proved metastases to the paraaortic lymph nodes from invasive cervical carcinoma treated with extended-field irradiation. Complications following treatment developed in five of 10 patients who underwent transperitoneal nodal biopsy or dissection and in two of eight patients in whom an extraperitoneal approach was used (overall complication rate of 39%); however, only one had a gastrointestinal complication (small bowel obstruction after transperitoneal nodal biopsy and irradiation). Fourteen patients had persistent or recurrent disease within the abdominal or pelvic cavity; only one had distant metastases without recurrence in the abdomen or pelvis. Two of the 14 patients had a recurrence in the surgical scar following extraperitoneal nodal biopsy, possibly due to placement of the scar outside the radiation field. After a minimum follow-up of 48 months, only three of 18 patients (17%) were alive and well.     

Molecular basis and prenatal diagnosis of beta-thalassemia

The molecular characterization of mutations producing beta-thalassemia in world populations is nearing completion. We expect that new rare alleles in thoroughly studied groups and other alleles in less studied groups, eg, inhabitants of New Guinea, Latin America, and certain Pacific Islands, will be found. Knowledge of the molecular basis of the disease and new technology that allows rapid detection of single nucleotide changes in genomic DNA have led to the reality of prenatal diagnosis by direct mutation detection even in the heterogeneous US population. Programs aimed at prevention of beta-thalassemia should be facilitated by these developments.