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Biomedical subjects

A Sella

Publications and source records attributed to A Sella.

At least 73 records · Page 4Linked to original sources
PubMed1989

Radiation therapy-associated invasive bladder tumors.

Radiotherapy-associated bladder carcinoma was found in 3.7 percent of 244 cases of advanced urothelial carcinoma. Average age at diagnosis of the bladder tumor was 63.1 years, with a mean of 20.5 years between radiation treatment and diagnosis. All 9 patients presented with gross hematuria. Eight patients had transitional cell carcinoma, 7/8 (87.5%) also had vascular or lymphatic invasion, and 1 was adenocarcinoma. Mean survival was 15.4 months (range 1-40 mos.), with a 55.5 percent one-year disease-free survival after diagnosis. Four patients died of bladder tumor, 4 were alive with no evidence of disease, and 1 was alive with metastasis.

Aged↗
PubMed1989

Clinical and radiological correlation of retroperitoneal metastasis from nonseminomatous testicular cancer treated with chemotherapy.

Forty patients with retroperitoneal metastasis from nonseminomatous testicular cancer treated with chemotherapy were retrospectively studied to (1) evaluate the predictive value of mass size as detected by computerized tomography (CT) as an indicator for postchemotherapy surgery and (2) determine the factors that influence relapse. Patients received two further courses of chemotherapy after their serum biomarkers became normal and computed tomography indicated a complete response or presence of a residual but stable mass. We found that patients with initial metastases less than 2 cm had a low frequency (14%) of residual masses after chemotherapy, vs. 59% for those with masses of 2-5 cm and 75% for those with masses of greater than 5 cm (P = 0.03). Of 22 patients with primary embryonal carcinoma, three of seven (43%) with residual masses after chemotherapy had mature teratoma at surgery. Six patients had small (1-2 cm) residual abnormalities that were not removed, and three of these patients relapsed. In conclusion, increasing size of retroperitoneal metastasis by CT scan predicts for increased likelihood of a residual mass after chemotherapy; patients who have a residual mass greater than or equal to 1 cm require retroperitoneal lymphadenectomy after chemotherapy, whether the tumor histology is embryonal carcinoma or teratoma. The role of surgery for patients who have residual retroperitoneal masses less than 1 cm after chemotherapy could not be determined from our study.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Cisplatin, cyclophosphamide and doxorubicin chemotherapy for unresectable urothelial tumors: the M.D. Anderson experience.

We reviewed retrospectively 97 patients treated with cisplatin, cyclophosphamide and doxorubicin chemotherapy at our hospital to evaluate predictive variables for response to chemotherapy and long-term survival free of disease. Histological subtype influenced response: 70 per cent of the patients with pure transitional cell carcinoma achieved an objective response (partial remission 31 per cent and complete remission 39 per cent), whereas 45 per cent of those with mixed tumors achieved response (partial remission 20 per cent and complete remission 25 per cent). Patients with nodal metastases only had an equal over-all response rate to those with visceral metastasis (64 versus 62 per cent) but patients with nodal metastases had a higher complete remission rate (45 versus 20 per cent). A total of 35 patients (36 per cent) achieved a complete response. In 17 of the 35 patients the duration of response was less than 100 weeks and 18 (51 per cent) have survived longer than 100 weeks. Of the 17 patients with a survival free of disease of less than 100 weeks 16 died of recurrent urothelial tumors and 1 died of a second primary tumor. Among the patients with a survival free of disease of longer than 100 weeks only 2 have had recurrent urothelial tumors; 72 per cent of the patients in this category remain free of disease. Patients with pure transitional cell carcinoma were represented in equal frequency among patients achieving a durable complete remission and those with a complete remission of less than 100 weeks. These data demonstrate the ability of cisplatin, cyclophosphamide and doxorubicin combination chemotherapy to achieve a complete remission and long-term survival free of disease among select patients with unresectable urothelial tumors.

Adenocarcinoma↗
PubMed1989

Interferon alternating with chemotherapy for patients with metastatic renal cell carcinoma.

A prospective randomized trial tested the hypothesis that interferon and cytotoxic chemotherapy delivered sequentially would be synergistic and would increase the response rate in metastatic renal cell carcinoma. Thirty-six patients were entered and randomized to chemotherapy only (5-fluorouracil, doxorubicin, mitomycin, and cis-platin) vs. interferon alternating with the same chemotherapy. Only 4 of 32 evaluable patients (13%), 2 in each arm, had a major response. Three patients in the alternating arm had minor responses. Complete, partial, and minor responses totaled 7 (22%). All four patients whose only disease was lung metastasis had some evidence of response (p = 0.001). Interferon alternating with chemotherapy did not appear to improve the major response rate over chemotherapy alone. Responses in metastatic renal cell carcinoma appear confined to a favorable subset of patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Genetic abnormalities in men with germ cell tumors.

We retrospectively reviewed the genetic abnormalities detected clinically in 455 men with advanced germ cell tumors referred for chemotherapy. Of the patients 49 had extragonadal and 406 had testicular germ cell tumors. Of 19 patients with mediastinal germ cell tumors 4 (21 per cent, 3 with teratocarcinoma and 1 with endodermal sinus tumor) had Klinefelter's syndrome. Three of these patients had a 47XXY and 1 had a 48XXYY karyotype. No Klinefelter's syndrome was observed among 30 consecutive patients with retroperitoneal germ cell tumors or among the 406 with testicular tumors. Karyotypes of 35 consecutive patients with testis cancer without evident congenital abnormalities showed normal chromosomal patterns. We found 2 patients with Down's syndrome and testicular tumor, for an incidence of 0.5 per cent (probably significant). We also describe 2 cases of nonseminomatous testicular cancer and Marfan's syndrome (0.5 per cent incidence versus a 5 of 100,000 incidence of Marfan's syndrome in the general population). Apparently, genetic abnormalities are increased in men with germ cell tumors and we discuss the significance of this association.

Adolescent↗
PubMed1988

Adjuvant cyclophosphamide, doxorubicin, and cisplatin chemotherapy for bladder cancer: an update.

Seventy-one patients received adjuvant Cytoxan (cyclophosphamide; Bristol-Myers Co, Evansville, IN), Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), and cisplatin (CISCA) chemotherapy between March 1981 and March 1986. Patients received adjuvant CISCA chemotherapy if they had pathological findings that were thought to predict for high likelihood of relapse. These included the presence of resected nodal metastases, extravesicular involvement of tumor, lymphatic/vascular permeation of the primary tumor, or pelvic visceral invasion. Sixty-two patients at a similar high risk for recurrence did not receive adjuvant CISCA chemotherapy because they refused, had medical contraindications to therapy, or were not referred for chemotherapy. Two-hundred six patients had a cystectomy performed during the same study period but had none of the poor prognostic features suggesting a high risk for relapse. Sixty-two percent of the patients receiving adjuvant chemotherapy are alive and disease-free for a mean follow-up of 118 weeks (range, 28 to 310 weeks). A survival advantage exists for the adjuvant-treated patients when compared with those with unfavorable pathological findings who did not receive adjuvant chemotherapy (70% v 37%) (P = .00012): no difference exists in long-term disease-free survival for those with favorable pathological findings (long-term disease-free survival 76%) v those who received adjuvant chemotherapy (70%) (P = .33). Adjuvant CISCA chemotherapy prolongs the disease-free survival of some patients following a cystectomy. Patients who benefitted from adjuvant CISCA chemotherapy included those with resected nodal metastases, extra-vesicular involvement of tumor, and direct invasion of the pelvic viscera. Patients not benefitting from adjuvant CISCA chemotherapy in this analysis included those with lymphatic/vascular invasion in their primary tumor as the sole manifestation of high risk for relapse.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Sarcomatoid renal cell carcinoma. A treatable entity.

Of 920 patients with histologically confirmed renal cell carcinoma (RCC) seen at University of Texas M. D. Anderson Hospital over a 10-year period, 44 (4.8%) had the sarcomatoid variant. The authors show that, although sarcomatoid RCC has as common denominators with classic RCC in certain epidemiologic parameters such as age and sex, its biologic behavior is different. It is more malignant, has a higher metastatic rate, ultimate recurrence in localized disease which translates to a shorter survival time. Metastasis at presentation, advanced age (older than 59 years) and female sex were a associate with a worse prognosis. This entity is characterized by a high incidence of bone metastasis at presentation (48%) and by a tendency toward pathologic bone fractures. All of the untreated patients died very soon after diagnosis (median, 3.8 months), whereas all of the patients treated with the various systemic modalities initiated only in the presence of metastatic disease survived significantly longer (median, 13.0 months). Of the eight patients who were treated with doxorubicin HCI chemotherapy regimens two (on CYVADIC) showed complete responses and are the only survivors (50, 65 months). Four patients treated with interferon had the longest median survival (41.0 months). These results suggest that CYVADIC chemotherapy should be combined with interferon in this entity. Since surgery is not curative in early stages of sarcomatoid RCC, adjuvant therapy with those agents should be considered.

Adult↗
PubMed1987

Sarcomatoid renal cell carcinoma: clinicopathologic. A study of 42 cases.

Forty-two cases of sarcomatoid renal cell carcinoma were reviewed clinicopathologically. Twenty-four patients were men, and 18 women; average age was 56.2 years (range, 30-81 years). Eight, 9, 13, and 12 cases were Stages I, II, III, and IV, respectively. Three morphologic patterns of sarcomatoid components were identified: malignant fibrous histiocytomatous (26 cases), fibrosarcomatous (6 cases), and unclassified sarcomatoid (10 cases). Mitotic count, degree of pleomorphism, cellularity, and amount of tumor matrix in the sarcomatoid areas, and similar morphologic parameters in the carcinomatous component all failed to correlate with prognosis, as did tumor size and renal vein involvement by tumor. Clinicopathologic stage was a most significant prognostic factor, with a survival of 49.7 months for Stage I and 6.8 months for combined Stages II, III, and IV. Tumor necrosis in the sarcomatoid area and proportion of sarcomatoid components were also poor prognostic factors. When these factors were compared to the stage, necrosis was an independent variable, however, proportion of sarcomatoid components was a poor prognostic indicator only for Stages I and II.

Carcinoma, Renal Cell↗
PubMed1987

Renal cell cancer: best recipient of tumor-to-tumor metastasis.

Three cases of malignant tumor metastasis to primary renal cell carcinoma (RCC) are described. We review the literature on this subject and emphasize the possible mechanisms of this observation in 46 patients described in the English literature. RCC is the most common tumor recipient of metastasis while carcinoma of the bronchus is most consistently the metastatic donor. This phenomenon is not as infrequent as previously thought and may be present in up to 15 per cent of patients with simultaneous RCC and second neoplastic disease.

Adenocarcinoma↗
PubMed1980

Eosinophilic pleural effusion with high anti-DNA activity as a manifestation of systemic lupus erythematosus.

A patient, known to have systemic lupus erythematosus (SLE), presented with an eosinophilic pleural effusion. It is believed that SLE was the cause of her pleural effusion as increased levels of anti-DNA activity were found in the pleural fluid. Eosinophilic pleural effusion is a previosuly unreported observation in SLE patients (so far as the authors are aware), and the existence of increased anti-DNA activity in the pleural fluid may have value as an additional aid in the diagnosis of this disease.

Antibodies, Antinuclear↗
PubMed1979

Adenocarcinoma of the lung secreting alkaline phosphatase.

A 42-year old male was found to have adenocarcinoma of the lung and very high serum alkaline phosphatase levels. The clinical course and autopsy excluded the possibility that the enzyme elevation was due to liver or bone metastases, which is the most common cause for such a phenomenon. It was proven that the tumor secreted the alkaline phosphatase, and that the latter could serve as a marker of its recidivation. Although the phenomenon of tumors secreting alkaline phosphatase is not new, including some types of lung carcinomas (such as squamous cell and epidermoid), it is, to the best of our knowledge, the first time adenocarcinoma of the lung was found to secrete the enzyme.

Adenocarcinoma↗
PubMed1979

Acute delirious state after epsilon-amino caproic acid administration.

Prior to intravenous pyelography, a patient known to have iodine hypersensitivity was injected intravenously with a bolus of 2 gm epsilon-amino caproic acid (EACA). Immediately following the injection the patient developed an acute episode manifested by a delirious state, with auditory, visual, and kinesthetic hallucinations. The entire episode lasted 8 min, and no residual psychiatric or neurologic symptoms were observed. To the best of our knowledge no such side effect of EACA has been reported so far.

Aged↗
PubMed1979

Pica diagnosed by abdominal X-rays.

A young Arab woman with pica is presented. The diagnosis was suggested by the recurrent presence of numerous radiopaque particles in the course of the gastrointestinal tract. The particles changed location and concentration in successive abdominal X-rays taken at intervals of several weeks. Pica and its implications are discussed.

Adult↗