Human genital tumors as well as recurrent laryngeal papillomas were analyzed for the presence of human papil, lomavirus (HPV)6 and HPV 11 sequences. HPV 11 DNA was found in 7 of 14 laryngeal papillomas; in the 7 other tumors no HPV DNA was demonstrated. HPV 11 DNA was also found in all five atypical condylomata of the cervix included in this study. Condylomata acuminata mainly contained HPV 6 DNA. From 63 biopsy specimens, 41 clearly harbored HPV 6 DNA and 13 harbored HPV 11 DNA. In three tumors accurate typing was impossible, and in six additional ones neither HPV 6 nor .HPV 11 DNA could be demonstrated. The data support a genital origin of laryngeal papillomavirus infections. In 4 of 24 malignant tumors, HPV 11 DNA or related sequences were demonstrated; 2 of the 4 were biopsy specimens from invasive cancer, and the other 2 originated from carcinomata in situ. A possible role of this or related papillomavirus types in the induction of malignant genital. tumors remains to be elucidated.

Different types of vulvar cancers can be found in squamous cell tumors of the anterior fourchette, similar to the finding in vulvar cancers from other locations and to what has previously been reported for vulvar squamous cell carcinomas in general.

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We retrospectively analyzed methods of follow-up and subsequent clinical outcome in 399 breast cancer patients treated with curative intent. Radioisotope liver scans, liver sonograms and laboratory investigations were of little value in detecting metastases. Mammography detected 2 of 6 contralateral breast cancers in an asymptomatic stage. Of 92 metastatic diseases, 24 were disclosed by a total of 871 radioisotope bone scans, and 17 were disclosed by a total of 2409 chest x-rays. The detection of distant metastases in an asymptomatic stage by diagnostic procedures vs detection by symptoms was not correlated with a survival benefit. The survival times for the two groups were 6.4 years vs 6.7 years (p = 0.7) after initiation of primary therapy, and 20.8 vs 20.4 months (p = 0.9) after the diagnosis of metastatic disease. Our study does not lend support to the hypothesis that the detection of metastatic disease in an asymptomatic stage or regular follow-up visits are associated with a survival benefit. We conclude that clinical history, physical examination, and mammography are the most important procedures in the follow-up of breast cancer patients.