Brief RECAPITULATION of results obtained from utilization of devitalization technique in treatment of malignant tumors
RNDr. Vratislav Horák, CSc

Attachment # 2 to the "Request for starting clinical tests of devitalization technique in healing malign tumors" handed over to the Czech Ministry of Health  by Drs. Fortýn and Horák on October 30, 2000.
Translation from the Czech original by Martin Tlusty.

 
   The Devitalization technique is an original, relatively simple surgical treatment procedure, developed by MUDr. Karel Fortýn, CSc for treatment of malignant tumors.
Its principle consists of isolation of tumor from vascular supply, which is accomplished by ligation of arterial and venous blood vessels.
The tumor, treated this way, is then left in the organism together with tumor's carrying tissue (e.g. parts of digestive tract)
.
At the beginning the Devitalization surgical treatments were made experimentally on various parts of digestive tract and internal organs on healthy miniature pigs (about 120 pcs) and on laboratory rats (almost 200 pcs) with the goal to work up the Devitalization technique and find out the organism response to this unusual surgical treatment.
With exception of several accidental deaths, related not to the own Devitalization surgical treatments (postoperative leakage of the intestinal anastomoses, vascular bleeding), the experimental animals survived the Devitalization treatments without any apparent health problems or any negative side effects. As it was generally proved by revision operations, the Devitalized tissue was, during several months, continually degraded (incl. the cases of small intestine and large intestine Devitalized in the length 180 cm, left in the abdominal cavity, together with all of its content). Therefore, there was only a small piece of fibrotic tissue found on its place. (Fortýn et al. 1985, 1987, 1988a, b, 1989)
    The experimental results, received after application of the Devitalization technique for treatment of the melanoma at the miniature pigs (of the line MeLiM, which was selected for this purpose in our institution), are as well successful and very promising for treatment of the human malignant tumors. The histopatologic laboratory findings of the primary melanoma and organ's metastases (Fortýn et al. 1994a, 1998, Hruban et al. 1998a, Horák et. al.1999), the basic biochemical characterization (Borovanský et. al. 2000a,b), detection of metastatic activity of melanoma based on finding of circulating melanoma cells in the peripheral blood (Pohlreich et. al. 2000a,b) and immunocytochemistry results in vivo (Geffrotin et. al. - Biochem Biophys Acta - received for printing) and in vitro (Horák et. al. 2000) show to the significant similarity between this type of the malignant tumor and a human melanoma.
It is necessary to stress that the melanoma belongs in the human area among the most aggressive malignant tumors. Its occurrence is gradually increasing in the white population during the last 10 years (it shows the most rapid increase among all tumorous diseases). Treatment of the patients suffering with melanoma in the later stages of disease, when there are metastases proved in the regional glands and visceral organs (stages III-IV), is practically ineffective (Villikka and Pyrhonen 1996, Keiholz et. al. 1997, Falkons et. al. 1998, Jungnelius et. al. 1998, Eggermont 1999).
In our laboratory, up till now, we have applied the Devitalization technique to almost 100 miniature pigs with the dermal melanoma (usually multiple ones) showing a vertical growth into the deeper layers of dermis, with histologically proved metastases (usually in the lymphatic glands and in the spleen, according to the human classification, in the disease stage III and IV).
After Devitalization of one of the dermal melanoma by the series of partly overlapping mattress-stitches, lead under the base of the tumor, a generalized disintegration and gradual clearance of melanotic cells in all dermal tumors and in all metastatic focuses was proved within 4-6 months (depending on size of tumors and extent of metastases) histologically (Fortýn et. al. 1994b, 1995; Horák et. al. 1998, 1999) and biochemically (Borovanský et. al. 2000b).
It is necessary to stress that such high specific potency on the tumor cells having no negative side effects on the healthy tissue is not displayed up till now at any other technique, used in the clinical oncology.
  The preliminary results from the Devitalization treatment of the breast carcinoma at dogs (by now 26 bitch dogs treated) show the positive therapeutic effect of this surgical treatment at the other type of tumor as well as at the other animal species.

    At conclusion of this listing of experimental results obtained from the Devitalization treatment of malignant tumors, it is necessary to emphasize its successful clinical application, too.
MUDr. Karel Fortýn has used this technique during his active surgical practice in the years 1957 - 1993 at about 20 patients with inoperable tumors (colorectal carcinoma, breast carcinoma and renal carcinoma), where it lead to the full recovery without any recurrence.
Explanation of the generalized destruction of the tumor cells in the organism following the Devitalization treatment is yet only speculative.
Series of the circumstantial evidence that we have, predicates that the tumor cells decaying in the devitalized tissue leads to the activation of the immune system cells, which causes (via some form of the cellular immune mechanisms) dying of the tumor cells in the entire organism - in the primary focuses as well as in the metastatic focuses.
Because of the presented results, we are convinced that the unique effect of the Devitalization treatment on the tumor tissue is not species-specific nor tumor type-specific, and could bring the positive results if used for treatment of some of the malignant tumors in the clinical practice, too.

LIST OF REPORTS, PRESENTING THE ACCOMPLISHED RESULTS

Borovanský et. al. (2000a) Chem Listy 94: 650-651    (in Cz)
Borovanský J et. al. (2000b) Pigment Cell Res 13: 398    (in E)
Fortýn K et. al. (1985) From exp Chir Transplant kunstlich Organe 18: 34-41    (in G)
Fortýn K et. al. (1987) Čas Lék čes 126: 309-305    (in Cz)
Fortýn K et. al. (1988a) Acta Chirurg Hung 29: 163-172    (in E?)
Fortýn K et. al. (1985) From exp Chir Transplant kunstlich Organe 21: 275-280    (in G)
Fortýn K et. al. (1989) From exp Chir Transplant kunstlich Organe 22: 173-179    (in G)
Fortýn K et. al. (1985) Vet Med-Czech 39: 597-604    (in Cz)
Fortýn K et. al. (1994b) Br J Surg 81: 146-147    (in E)
Fortýn K et. al. (1995) Klin Onkol 1: 11-15    (in Cz)
Fortýn K et. al. (1998) Vet Med-Czech 43: 87-91    (in Cz)
Horák V et. al. (1998) Pigment Cell Res 11: 254    (in E)
Horák V et. al. (1999) Cell Mol Biol 45: 1119-1129    (in E)
Horák V et. al. (2000) Pigment Cell Res 13: 397-398    (in E)
Hruban V et. al. (1998a) Veterinářství 48: 192-196    (in Cz)
Hruban V et. al. (1998b) Folia Biol 44: 84    (in Cz)
Pohlreich P et. al. (2000a) Abstracts(No.725) 18th Int Congr Biochem Molec Biol, Birmingham    (in E)
Pohlreich P et. al. (2000b) Chem Listy 94: 540-541    (in Cz)

LIST OF QUOTED REPORTS

Eggermont A (1999) Clinical Management of Malignant Melanoma; Colwoods House Med Publ, UK    (in E)
Falkons CI et. al. (1998) J Clin Oncol 16: 1743-1751    (in E)
Junghnelius U et. al. (1998) Eur J Cancer 34: 1368-1374    (in E)
Keiholz U et. al. (1997) J Clin Oncol 15: 2579-2588    (in E)
Villikka K and Pyrhonen S (1996) Ann Med 28: 227-233    (in E)

Liběchov, October 27, 2000         RNDr. Vratislav Horák, CSc.