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Interviewing and examination of a population characterized by a high level of morbidity of oral cavity cancer, supposedly induced by the use of nas, established a high incidence of leukoplakia and preleukoplakia at this site which are identified as precancerous lesions. The highest relative risk of oral cavity leukoplakia was found in persons who both chew nas and smoke tobacco (12.4). Relative risk of leukoplakia is also elevated in those who either chew nas (5.6) or smoke cigarettes (7.7). This risk increases in step with the quantity of nas consumed per day as well as the number of cigarettes. The scrapings obtained from the oral cavity mucosa of nas chewers and cigarette smokers were shown to contain relatively higher levels of micronuclear cells. The results of this and previous investigations suggest that tests for the frequency of micronuclear cell occurrence may prove instrumental in identifying the early signs of carcinogenesis as well as in evaluating the efficacy of prophylactic measures.

Out of 2018 patients, skin melanoma occurred in IO2 (5%) cases during pregnancy. Three-, five- and ten year survival was analysed in the latter cases versus term of pregnancy, abortion and the stage of the disease. Also comparison was made between the said group, another 42 females who developed tumors during lactation period and 599 normally-cycling females of reproductive age who were not pregnant when melanoma appeared (controls). Significantly lower 10-year survival was observed in pregnant patients, as compared with those who were not pregnant (p less than 0.05). Five- and ten-year survivals were significantly lower in cases of stage I tumor during the latter half of pregnancy than in skin melanoma patients who were not pregnant (p less than 0.05). Abortion during the first half of pregnancy was found to produce an adverse effect on prognosis in stage I tumor patients while this effect was reversed in stage II tumor. No significant differences were found between 3-, 5- and 10-year survival in melanoma patients who had pregnancies before the disease and those who had not (p greater than 0.05).

The effect of adjuvant chemotherapy on survival and prognosis in osteogenic sarcoma versus basic clinico-roentgenomorphological characteristics of tumor was studied in 108 cases. Prognosis was found to depend on patient's age, site and size of tumor, but mainly on the roentgeno-morphological pattern of the latter. Osteolytic form appeared to have a better course in cases of adjuvant chemotherapy. This was matched by osteoplastic form requiring surgical treatment only. The results suggest a strictly differentiated approach to selection of treatment modality, particularly in cases of post-operative chemotherapy.

Seven incurable patients with disseminated malignant melanoma were injected (subcutaneously, sometimes intravenously) with homogenate of bovine pineal tissue. The daily injections of large quantities of pineal tissue appeared to be harmless for patients. Many-fold injections (during 9.5 months) of large quantities of pineal tissue (up to 3950 g) in 1 of 7 cases produced certain effect on subcutaneous metastases of malignant melanoma, i.e. causing reduction and even disappearance.

The main principles and the structure of the cancer control organization in the USSR are described. The trends in the incidence of selected forms of malignant tumors and regional differences in USSR are documented with statistical data.

The experience in the management of 246 patients with local osteogenic sarcoma and 67 patients with pulmonary metastases in the All-Union Oncologic Research Center, AMS USSR, is presented here. All the patients underwent surgery, but starting in 1974, various modalities of adjuvant chemotherapy (not randomized) were applied in addition. In the surgery alone group, prognosis was very poor: only 7.0% of patients survived free of disease 5 years from the primary tumor treatment. Adjuvant chemotherapy (adriamycin + vincristine + melphalan + cyclophosphamide) following amputations increased this rate to 34.0%; combining segmental resections of an affected bone with preoperative intraarterial adriamycin infusion and radiation (36 Gy) increased the rate to 35.5%. In patients with grade 4 tumor damage (tumor cells are not found upon examination of a large number of sections), the rate increased to 57.9% (P less than .05). Another regimen of adjuvant chemotherapy (platidiam or cisplatin + adriamycin + cyclophosphamide) gives a chance to 78.8% of patients to survive 1 year free of metastases. The same chemotherapy regimen enables us to achieve an objective effect in 30.8% of patients with pulmonary metastases, and its combination with surgical metastasis ablation makes it possible to obtain a complete remission, lasting from 2 to 46 months (average 13.9 months). Toxic manifestations of the chemotherapy regimens considered are moderate. Prognosis in adjuvant chemotherapy is related to age, tumor site, its local dissemination, and morphologic type of osteogenic sarcoma.

Homovanillic acid (HVA) was determined both in 45 patients with different forms of melanoma and those hospitalized on the suspicion of melanoma and in 15 healthy persons. Excretion rate of homovanillic acid within the normal limits was observed in patients with benign melanotic neoplasms of the skin (4.4 +/- 0.56 mg/24 hr) and in local forms of melanotic melanoma of the skin (4.5 +/- 0.24 mg/24 hr). In patients with metastases to regional nodes as well as in patients with locally disseminated forms of melanotic melanoma of the skin the concentration of homovanillic acid increased up to 11.1 +/- 0.93 mg/24 hr. Especially strong concentration of homovanillic acid was registered in patients with disseminated malanotic melanoma of the skin, and it made up 15.7 +/- 2.04 mg/24 hr. There was evident tendency to the elevation of HVA excretion level as generalization of the process which was taking place. The data obtained enable the authors to recommend the determination of HVA excretion as an additional diagnostic test as well for prognosis of melanoma development together with other clinicomorphological data.

From September, 1967, to January, 1974, a clinical trial was carried out by the WHO Melanoma Group to evaluate the efficacy of elective lymph-node dissection in the treatment of malignant melanoma of the extremities with clinically uninvolved regional lymph nodes. Treatment was prospectively randomized: 267 patients to excision of primary melanoma and immediate regional-lymph-node dissection and 286 to excision of primary melanoma and regional-lymph-node dissection at the time of appearance of metastases. The statistical analysis showed no difference in survival between the two groups of patients, regardless of how the data were analyzed (according to sex, site of origin, maximum diameter of primary tumor or Clark's level or Breslow's thickness). Elective lymph-node dissection in malignant malanoma of the limbs does not improve the prognosis and is not recommended when patients can be followed at intervals of three months.

Estradiol-17β receptors were detected in the cytosolic fraction of the majority of bone chondrosarcomas by protamine sulfate sedimentation of the hormone-receptor complex. The absolute number of receptors in tumors was higher in men than in women, but chondrosarcomas with estradiol-17β receptors more often occurred in women. The highest level of receptors was revealed in highly differentiated chondrosarcomas. No relationships between tumor location, size, type of the process, and the number of receptors was detected. We can state with assurance that the absence of estradiol-17β receptors in chondrosarcomas in women is a favorable prognostic sign with regard to metastases or local tumor relapses.

In human primary bone tumors of various histological origins, metabolism of testosterone led to the formation of 5α-reduced metabolites (mainly 5α-androstane-3α, 17β-diol, and 5α-androstane-3β-17β-diol), but not 5α-dihydrotestosterone. Transformation of 5α-dihydrotestosterone to other metabolites in human primary osteosarcomas is assumed to be associated with its inactivation or involvement of metabolites of this androgen in unknown regulatory mechanisms in bone tumors. Therefore,in vitro evaluation of 5α-reductase activity in human primary osteosarcomas and other tumors by 5α-dihydrotestosterone formation could yield erroneous results.

Endocrinologic examination of 320 male patients with primary osteogenic sarcoma reveals predominance of hyperandrogenemia characterized by decreased levels of sex hormonebinding globulin, elevated testosterone concentration, and increased free androgen index. The occurrence of androgen receptors was similar in the cytosolic fraction of osteogenic sarcoma (56%), benign tumors and tumor-like bone lesions (50%), while their content was higher in osteogenic sarcoma, implying an unfavorable prognosis of metastasizing.

The comparison of activities of the key enzymes of androgen metabolism in morphological variants of bone sarcomas and benign tumors suggests that malignant tumors of different histogenesis not only metabolize the main androgen testosterone, but also inactivate 5α-dihydrotestosterone, the main regulatory androgen in bones. It is possible that androgen metabolism in bone tumors is aimed at the formation of other androgens, in particular, 3α-and 5β-diols, which can be involved in regulatory processes in bone tissue. Further studies will disclose clinical significance of androgen metabolism and individual androgens in human bone tumors.

The concentrations of vascular endothelium growth factor and angiogenin were measured by enzyme immunoassay in the sera of healthy subjects and patients with osteosarcoma and Ewing's tumor with consideration for the main clinical and morphological characteristics of the diseases. The studied angiogenic factors were characterized by high individual variability in both healthy subjects and age- and sex-matched patients with primary bone sarcomas. The level of endothelial growth factor was higher in control women than in men. The highest concentration of endothelial growth factor was detected in male patients with Ewing's tumor. Possible involvement of vascular endothelium growth factor and angiogenin in the pathogenesis of osteosarcoma and Ewing's tumor is discussed.