[Clinical aspects of premature detachment of the placenta, placenta accreta and placenta increta (author's transl)].
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Biomedical subjects
Publications and source records attributed to A Pfleiderer.
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The results of the treatment of 1022 ovarian cancers were reviewed and the problems of prophylactic chemotherapy, a second look operation and the maintenance of the remission were studied. In ovarian cancers of stage 1 and stage 2, a post-operative prophylactic chemotherapy is useful only in cases with tumor cells in the secretions of the pouch of Douglas or in the ascites and in cases where a sensitivity to the chemotherapy can be assumed. In about 50% of primarily inoperable stage 3 ovarian cancers, the random treatment with cyclophosphamide (Endoxan) results in a clinical remission. A significant five year cure rate can only be obtained if the uterus and the adnexa are removed. Radical operation during the remission appears to be very important for survival of the patient. For the maintenance of the remission continuous chemotherapy for at least 2 years following treatment by operation and radiotherapy is necessary.
Ifosfamide or cyclophosphamide was employed in an alternating series in 49 advanced ovarian carcinomas. The two cytostatic drugs were given in single massive doses. In primary inoperable ovarian carcinomas at stage III and IV a partial remission occurred in 8 of 19 cases (42%) after treatment with cyclophosphamide. Ifosfamide produced a partial or complete remission in 9 of 11 cases (82%). However, 3 patients treated by ifosfamide died within 3 weeks after the administration of the first massive dose. Regarding these cases as failures there was a remission in 9 of 14 cases (64%). Cyclophosphamide enabled a secondary radical operation in 7 of 19 (37%), ifosfamide in 6 of 14 cases (43%). The intervals between an exploratory laparotomy and the secondary radical operation were 5 months on the average for the two cytostatic drugs.
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