The role of the sentinel lymph node in gastrointestinal cancer

Evaluation of the clinical significance of the sentinel node concept in GI cancer has just begun. The authors' preliminary data, using intraoperative radiation techniques and the gamma probe, suggest that it is worthwhile to continue the evaluation of this procedure to determine its role in an accurate staging and a minimally invasive approach to GI cancers.     

Steroids decrease uptake of carboplatin in rat gliomas – Uptake improved by intracarotid infusion of bradykinin analog, RMP-7

A blood-tumor barrier (BTB) limits delivery of antitumoragents to brain tumors. This study sought todetermine whether dexamethasone (DXN) treatment of rats withintracranial gliomas would 1) further impair delivery ofcarboplatin to brain tumors, and 2) whether intracarotidinfusion of the bradykinin analog, RMP-7, would improvedelivery during concurrent DXN treatment. Wistar rats withRG2 gliomas were utilized and a unidirectional transport,Ki, of radiolabeled [¹⁴C] carboplatin was determined usingquantitative autoradiography. In DXN pretreatment animals, 3 mg/kg/dayof DXN was administered intraperitoneally for 3 daysprior to Ki determinations. At 10 days aftertumor implantation, Ki of [¹⁴C] carboplatin into DXN-treatedtumors and brain surrounding tumor (BST) was significantlylower compared to non-DXN treated tumors and BST(3.30 ± 0.91 vs. 4.47 ± 1.80, p< 0.05, and 0.94 ± 0.84 vs. 2.18± 0.79, p < 0.05, respectively). Intracarotid infusionof RMP-7 (0.1 mg/kg/min) significantly increased the Kifor carboplatin in DXN-treated tumors (6.35 ± 3.10vs. 3.30 ± 0.91, p < 0.01), however, RMP-7increased Ki to a greater extent in tumorsnot pretreated with DXN (12.07 ± 3.60 vs.4.47 ± 1.80, p < 0.0001). Our studiesshow that dexamethasone decreases transport of carboplatin intobrain tumors. Intracarotid infusion of RMP-7 selectively increasescarboplatin transport to tumors.     

Transarterial Infusion of Cisplatin and Doxorubicin in Bladder Cancer: Original Article

Forty-five patients (median age 63 years) with muscle invasive bladder cancer were treated with transcatheter intraarterial infusion (TAI) of cisplatin (CDDP) and doxorubicin. They received a total of 114 courses (median 3 courses per patient) of TAI. Complete response was obtained in 20 patients (44%), partial response in 17 (38%), stable disease in 6(13%), and progression of disease in 2 patients (5%). The overall response rate was 82% at a median follow-up of 36 months. The actuarial survival of the patient population was 72% at 5 years; 36 patients were alive and 9 had died of cancer progression. The treatment was generally extremely well tolerated without major complications. The current study also revealed the fact that papillary carcinomas were more sensitive to this therapy than were non-papillary tumors. Overall, response rate and local control were significantly higher in low-grade than in high-grade tumors. The observed high complete response and good survival rate suggest that intraarterial CDDP and doxorubicin might be highly effective for localized invasive bladder cancer.     

Sarcomatoid chordoma: chordoma with a massive malignant spindle-cell component

We report a case of chordoma containing a spindle cell sarcomatoid component with a gradual transition from conventional chordoma. Immunohistochemically, many tumor cells in both conventional chordoma and sarcomatoid components were positive for cytokeratins (AE1/AE3, CAM5.2) and epithelial membrane antigen as well as vimentin. This report provides a rare example of sarcomatoid chordoma. Familiarity with this type of bone tumor should help to avoid confusion with dedifferentiated chordoma and other spindle cell sarcomas or carcinomas. Received: 25 February 2000 Revision requested: 28 March 2000 Revision received: 30 May 2000 Accepted: 28 June 2000