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Biomedical subjects

A Jakobsen

Publications and source records attributed to A Jakobsen.

At least 91 records · Page 5Linked to original sources
PubMed1989

CA 125 in the diagnosis of pelvic masses.

CA 125 was measured preoperatively in 184 female patients presenting with pelvic masses. Ovarian tumors were diagnosed in 151 cases (91 carcinomas, eight borderline, 52 benign) and non-ovarian tumors in 33 (19 malignant, 14 benign). The sensitivity of CA 125 in identifying the malignant and borderline ovarian tumors was 86%, the specificity 78%; and the positive and negative predictive values 82% and 83%, respectively. Increased antigen values (greater than 35 U/ml) were observed in 63% of the non-ovarian malignant tumors. Considering only the diagnosis of malignancy in pelvic masses (ovarian plus non-ovarian malignant tumors) the specificity improved to 89% and the positive predictive value to 93%; the sensitivity and the negative predictive value decreased to 82% and 74%, respectively. CA 125 in the normal range (less than or equal to 35 U/ml) was observed both in ovarian and non-ovarian carcinomas. Therefore, preoperative CA 125 values in the normal range should be interpreted with caution. However, increased preoperative CA 125 levels in patients with pelvic masses are highly suggestive of a malignant tumor and CA 125 should be an adjunct to the preoperative diagnostic armamentarium.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1989

Pharmacokinetics of oral idarubicin in breast cancer patients with reference to antitumor activity and side effects.

The pharmacokinetics of orally administered idarubicin (22.5 mg/m2/week) and idarubicinol were studied for 12 weeks in 14 patients with breast cancer. Plasma concentrations were monitored for 72 hours after the first, fourth, and twelfth doses and trough concentrations after 1, 2, 3, 4, 5, 7, 11, and 12 weeks of treatment. The half-lives of idarubicin and idarubicinol were 19 and 60 hours, respectively. No time-dependent changes or cumulation were observed. The metabolic ratio showed little variation. The plasma AUCs of idarubicin and idarubicinol varied between patients but were fairly constant in individual patients. The sum of the plasma AUCs was lower in patients with rapid progression than in patients who responded to treatment. A correlation between this parameter and the relative decrease in the leukocyte counts was demonstrated (p less than 0.05). No correlation was found between the pharmacokinetic parameters and the time to final progression.

Administration, Oral↗
PubMed1989

A new histologic grading index in ovarian carcinoma.

It is generally believed that the degree of differentiation or tumor grade is of prognostic value in human ovarian carcinoma, but the methods of evaluation are subject to considerable variation. The present work investigates the prognostic value of a new Histologic Grading Index (HGI), containing most of the known systems and taking into account both the usual histologic and cytologic features (tumor structure, nuclear polymorphism, nucleolar features, nuclear-cytoplasmic ratio, frequency of mitosis) and the probably more independent parameters (mode of invasion, capsular penetration, and vascular invasion). This study shows that the index correlates significantly with both presence of tumor at second-look operations and survival.

Female↗
PubMed1989

Preoperative measurement of cancer antigen 125 (CA 125) in the differential diagnosis of ovarian tumors.

The purpose of the present study was to evaluate the information preoperative measurements of cancer antigen 125 (CA 125) may give concerning the nature of an ovarian tumor. Serum samples from 61 patients were analyzed and the results compared with regard to malignancy, FIGO-stage, and histologic type of the tumor. All patients were deemed to have a malignant tumor by clinical examination. Elevated serum levels (greater than 35 U/ml) were found in 44 patients and of these patients 38 had carcinomas, 5 had borderline tumors, and one had a benign tumor (false positive). Normal serum levels (less than or equal to 35 U/ml) were registered in 17 patients. Fourteen of these had benign tumors and 3 had malignant (false negative). The false positive sample and the 3 false negative samples observed in the present study result in a positive and negative predictive value of the CA 125 analysis of 98% (43/44) and 82% (14/17) respectively. The positive predictive value of the clinical examination was 75% (46/61). It is concluded that measurement of CA 125 is a valuable adjunct to the preoperative examination of patients with ovarian tumors.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1989

Oral idarubicin in the treatment of advanced breast cancer.

Idarubicin (IDA), a more lipophilic derivative of daunorubicin, has shown activity after oral administration. In November 1983 we initiated a phase II study administering IDA, 45 mg/m2, in a 3 weekly schedule as first line chemotherapy to postmenopausal women with advanced breast cancer. Among 50 eligible patients a response rate of 36% (95% confidence interval (CI): 23-51) was obtained. Median time to treatment failure was 22 weeks (95% CI: 15-32). In November 1986, a sequential phase II study with IDA given in a weekly schedule was initiated. Patient characteristics was comparable to the first study. Among 53 evaluable patients, the response rate was 34% (95% CI: 22-48), and median time to treatment failure was 19 weeks (95% CI: 13-33). Therapeutic efficacy in the two studies was comparable and similar to published data on doxorubicin. Hematologic toxicity was equal while non-hematologic toxicity was considerably lower in the weekly schedule. A phase III comparison of IDA to doxorubicin or epi-doxorubicin is warranted, in order to clarify the role of IDA in the treatment of advanced breast cancer.

Administration, Oral↗
PubMed1989

Diagnostic value of lymphography in cervical cancer stage Ib.

The value of lymphography in the diagnosis of lymph node metastases was investigated in 89 patients with stage Ib cervical carcinoma. All patients underwent radical hysterectomy. The lymphography (radiological diagnosis) was compared with the histopathological examination of the corresponding lymph nodes. The positive predictive value of the lymphography was 13% and that of the negative predictive value 98%. It is concluded that lymphography is not reliable for the diagnosis of lymph node metastases in cervical cancer stage Ib.

Female↗
PubMed1989

Bladder tumour treatment in the aarhus region. 25 years of experience.

We report on the clinical studies of bladder tumours carried out at the centre for oncology in the Aarhus area and describe the experience and results of the past three decades. The 1960's saw the replacement of intracavitary techniques with external megavoltage irradiation. In the 1970's a large-scale regional trial was conducted assessing irradiation, which was now the dominant treatment principle, at all stages of the disease. In the 1980's a country-wide randomized trial was designed to compare the effect of cystectomy and definitive irradiation and to address the quality of life question. The report also mentions several associated projects on epidemiology, diagnostics (urinary cytology, DNA distribution) and factors pertinent to treatment (radioprotective agents, CT-based dose planning). Finally, we describe a country-wide randomized trial on the use of adjuvant chemotherapy scheduled for the 1990's.

DNA, Neoplasm↗
PubMed1989

Quality of life in patients with advanced bladder cancer. A randomized study comparing cystectomy and irradiation--the Danish Bladder Cancer Study Group (DAVECA protocol 8201).

The "quality of life" after treatment for advanced bladder cancer was investigated. The study was part of a randomized trial comparing the effect of preoperative irradiation (40 Gy) and cystectomy with radical radiation therapy (60 Gy) and salvage cystectomy. Patients answered a mailed questionnaire on psycho-social aspects. The first was filled in 6 months after treatment and was answered by 107 patients. The second was sent out 12-18 months later and was answered by 68 patients. From a general point of view, there were no consistent differences between the two treatment groups. In the first questionnaire, patients treated with radical irradiation and salvage cystectomy expressed a slightly more pessimistic outlook than patients treated with pre-operative irradiation and cystectomy. There was not such difference in the second questionnaire, but the latter group reported the largest reduction of social (sports, hobbies, etc.) and sexual activities. In conclusion, pre-operative information about treatment and post-operative life is an important but often neglected issue.

Combined Modality Therapy↗
PubMed1989

In vitro stability of the immunoreactivity of the ovarian cancer-associated antigen CA 125.

A commercially available two-site solid phase radio-immunoassay was used to study the influence of time and temperature on the in vitro stability of CA 125. In whole blood samples stored at 20 degrees C the CA 125 immunoreactivity increased significantly after 2 days of storage. However, serum could be stored at 20 degrees C for 3 days and at -20 degrees C and -80 degrees C for three weeks without statistically significant changes in the CA 125 immunoreactivity. Therefore, for storage up to 3 days at 20 degrees C, serum should be preferred. For prolonged storage serum samples should be kept at -20 degrees C or -80 degrees C.

Antigens, Neoplasm↗
PubMed1988

Measurement of the ovarian cancer-associated antigen CA 125 prior to second look operation.

CA 125 was measured in serum samples from 81 patients with a diagnosis of epithelial ovarian cancer. The samples were drawn prior to second look laparotomy performed in patients with complete or partial clinical remission after finishing cytostatic or radiation treatment. The positive and negative predictive value of the CA 125 measurements was 100% and 64%, respectively; the sensitivity and specificity were found to be 44% and 100%, respectively. At the second look operation no evidence of disease was observed in 40 patients, microscopic tumor was found in 10, and macroscopic tumor in 31 patients. All 81 patients had a gynecologic examination under anesthesia prior to the second look operation. Measurement of CA 125 was found superior to this examination with respect to positive and negative predictive value as well as to sensitivity and specificity. It is concluded that CA 125 values above 35 U/ml without exception announced residual tumor. Therefore, in cases with elevated CA 125 values, gynecologic examination under anesthesia or explorative laparotomy gave no further information concerning the result of treatment. CA 125 levels below 35 U/ml were without predictive value owing to a high number of false negative results.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1988

Prognostic influence of ploidy level and histopathologic differentiation in cervical carcinoma stage Ib.

Flow-cytometric DNA analysis and extended histopathologic grading were performed in specimens from 126 patients with squamous cell carcinoma of the uterine cervix stage Ib. Archival material was used for the measurements and the ploidy level was analysed according to the method described by Hedley with some modifications. The histopathologic grading was based on eight well-defined parameters all scored 1-3. The results showed that the ploidy level held significant prognostic information about the 10 year survival according to a division of DNA indices above and below 1.5. Further prognostic information appeared from a combination of DNA index and histopathologic score value. The combination held its prognostic importance in subgroups of patients with different tumour sizes. It is concluded that flow-cytometric analysis and histopathologic grading can identify subsets of patients who need more aggressive treatment.

Carcinoma, Squamous Cell↗
PubMed1988

DNA profile and steroid receptor content of human ovarian cancer.

The cellular DNA content was measured in 37 biopsy specimens from human malignant ovarian tumours by flow cytometric analysis. The same specimens were processed for measurement of steroid receptor content. In 14 cases both parameters were investigated in different parts of the same tumour. The results showed that 54% of the tumours contained aneuploid cell populations. Approximately half of the specimens were oestrogen receptor positive whereas 43% contained progesterone receptors. Both ploidy level and steroid receptor content proved constant throughout the tumour, but no relation between the two parameters was demonstrated.

Biomarkers, Tumor↗
PubMed1987

A randomized study of cyclophosphamide and cis-platinum with or without doxorubicin in advanced ovarian carcinoma.

Two hundred sixty-seven patients with advanced epithelial ovarian carcinoma were randomized to cis-platinum and cyclophosphamide versus cis-platinum, cyclophosphamide, and doxorubicin. Complete pathological response, evaluated at second-look laparotomy and survival, showed no differences between the two treatment groups. Recurrence-free survival after negative second look was 61% at 24 months.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Cyclic hormonal treatment in ovarian cancer. A phase-II trial.

Twenty-nine patients with advanced epithelial ovarian cancer were included in a phase-II trial of cyclic hormonal treatment. The schedule consisted of tamoxifen 10 mg X 3 daily for 14 days followed by medroxyprogesterone acetate 400 mg X 2 daily for 14 days. No objective response was recorded in 17 evaluable patients and cyclic hormonal treatment appears to be ineffective in advanced ovarian cancer.

Antineoplastic Combined Chemotherapy Protocols↗