[Studies of radiation effects on intestines in telecobalt therapy of ovarial neoplasms].
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Animals↗
Biomedical subjects
B Frankendal
Publications and source records attributed to B Frankendal.
Nuclear DNA content, proliferative activity, and p53 expression related to clinical and histopathologic features in endometrial carcinoma.
The purpose of this study was to evaluate the prognostic impact of image cytometry DNA ploidy, MIB-1, and p53 in relation to clinicopathologic variables in 376 consecutive patients with endometrial carcinoma stages I-IV. Following primary treatment 358 patients were considered tumor-free. Relapses and tumor-specific deaths of these patients were noted. Image cytometry DNA ploidy (n = 340) and expression of MIB-1 (n = 318) and p53 (n = 323) were studied. In univariate analysis, stage (P < 0.001), histopathologic subtype (P < 0.001), degree of differentiation (P < 0.001), HRT (P = 0.034), DNA ploidy (P < 0.001), and p53 (P < 0.001) were significant predictors of relapse. Patient age showed that the estimated mean risk of relapse increases with nearly 64% per decade in life (P 0.003), and the MIB-1 expression with 21% per 10-unit increment (P 0.004). In multivariate analysis, degree of differentiation, MIB-1, and p53 lost their prognostic capability. However, after stage and histopathologic subtype, image cytometry DNA ploidy was the strongest predictor of outcome and was of value in predicting the risk for relapse. The combination of DNA ploidy, MIB-1, and p53 expression was an even stronger predictor of relapse-free survival than the individual prognostic factors.
Adenocarcinoma↗
Pathologic complete remission after preoperative intracavitary radiotherapy of cervical cancer stage Ib and IIa is a strong prognostic factor for long-term survival: analysis of the Radiumhemmet data 1989-1991.
The purpose of this study was to evaluate the treatment results of preoperative brachytherapy and the prognostic value of pathologic complete remission after preoperative intracavitary irradiation in patients with stage Ib and IIa cervical carcinoma in relation to recurrence rate and survival. The clinical records of 185 patients with stage Ib (129 patients) and IIa (56 patients) cervical carcinoma, consecutively admitted to Radiumhemmet from January 1989 to December 1991 were reviewed. The median follow-up time was 71 months. In 121 patients the treatment consisted of uterovaginal intracavitary irradiation, according to the Stockholm technique, followed by surgery. Tumor remission assessed in the surgical specimen was classified as pathologic complete remission (pCR) if no microscopic tumor was found or incomplete pathologic remission (non-pCR) if microscopic residual tumor was found. Postoperative external beam radiation was added to cases with metastases in pelvic nodes or residual tumor in the resection margins. The disease-specific 5-year survival was 87% and 75% for stage Ib and IIa, respectively, for the patient population treated with preoperative intracavitary radiotherapy and surgery. After intracavitary radiation, 79% of the patients obtained pCR of the primary tumor. Five-year survival in those with pCR was 95%, compared with 46% in those with non-pCR (P < 0.0001). Patients with pCR and no lymph node metastases had a 98% 5-year survival as compared to a 5-year survival of 64% in patients with non-pCR and node negativity (P < 0.0001). Locoregional relapses were diagnosed in 2% of the patients with pCR compared to 54% in patients with non-pCR (P < 0.0001). Multivariate analysis revealed non-pCR (RR = 6.42) and node positivity (RR = 4.59) as nonfavorable factors for survival, while tumor size was not found to be of independent significance for survival. Pathologic complete remission after intracavitary irradiation is a strong favorable prognostic factor in node-negative patients. The combination of preoperative intracavitary radiotherapy and surgery results in a high cure rate and aids in identifying patients at risk for relapse who might be subject to adjuvant therapy.
Brachytherapy↗
Primary carcinoma of the vagina: factors influencing the age at diagnosis. The Radiumhemmet series 1956-96.
The objective to this retrospective study of 341 cases of primary carcinoma of vagina (PCV) diagnosed between 1956 and 1996 was to find whether epidemiological, clinical, and histopathological variables were related to the age at diagnosis of patients with PCV. The univariate statistical analysis showed that younger age at diagnosis significantly correlated with a history of cervical dysplasia, hysterectomy, gynecological infections, and tumors located in the upper part of the vagina, whereas older age at diagnosis significantly correlated with late menarche and exophytically growing tumors. In the multivariate regression analysis, the remaining independent predictors were a history of cervical dysplasia and age at menarche. Further, parity >/=4 as well as nulliparity, smoking, and unstable marital status were more common among patients with PCV than among those in the general Swedish female population. This study indicates that the etiology of vaginal carcinoma may be age related. In young patients, the disease seems to be etiologically related to cervical neoplasia and thus human papillomavirus (HPV) dependent. However, in the most common age group, the older patients, there might be another (probably non-HPV-related) etiology associated with hormonal factors and trauma to the vagina.
Adenocarcinoma↗
Clinical and histopathologic factors related to prognosis in primary squamous cell carcinoma of the vagina.
The goal of this retrospective study concerning primary carcinoma of the vagina (PCV) was to analyze clinical and histopathologic prognostic factors in one of the largest known material, which comprised 314 patients. PCV is a rare disease, and the majority of published studies are based on small materials; therefore, the established knowledge concerning prognostic factors is insufficient. Routine treatment is based on irradiation with risk for undertreatment or overtreatment, which leads to unnecessary complications in the absence of prognostic factors. The overall 5-year disease-specific survival rate in this study was 45% and in stage I 75%. In the univariate statistical analysis, several factors correlated significantly with disease-specific survival. However, in the multivariate analysis, there were only three factors that independently could predict poor survival-high age at diagnosis, large tumors (> or =4 cm), and advanced stage. Common background factors with no prognostic significance were prior hysterectomy, other gynecological malignancies, and pelvic irradiation. In conclusion, this study has elucidated three strong prognostic factors that might be considered in the choice of therapy and also for modification of the FIGO guidelines. Increased knowledge concerning complementary biologic markers to discriminate between low- and high malignant tumors is however of great importance.
Adult↗
Flow cytometric DNA patterns in cervical carcinoma.
Flow cytometric measurements of the DNA content were performed in a prospective study of 167 women with invasive squamous cell carcinoma of the uterine cervix. Ploidy level and the proportion of S-phase cells were correlated to age, menopausal age, staging according to FIGO and histopathology. With increasing age a successive shift from a dominance of peri-diploid and peri-tetraploid values to marked aneuploidy was found. Peri-diploid and peri-tetraploid tumors were more often found in premenopausal than in post-menopausal women (p less than 0.001). The mean S-phase rate was significantly higher in women aged 60-89 years than in women aged 20-59 years (p less than 0.01). More aneuploid tumors were found in stages III and IV than in stages IB and II (p less than 0.01). The mean S-phase rate was higher in stages III and IV (20.8%) than in stages IB and II (17.2%) (p less than 0.01). No statistically significant correlation was shown between ploidy level and histopathology or between S-phase rate and histopathology. In 37 patients polyclonal tumors were found. The reproducibility of the method was good (r = 0.99).
Adult↗
S-phase rate as a predictor of early recurrences in carcinoma of the uterine cervix.
Flow cytometric measurements of ploidy level and S-phase rate were performed in a prospective study of 165 patients with cervical squamous cell carcinoma. Patients were followed-up for 24 months after initial treatment. There was no significant difference in recurrence rate between patients with peri-diploid tumors (1.8c-2.2c) and aneuploid tumors. The S-phase rate (evaluable in 133 cases), which previously has been studied only occasionally in cervical carcinomas, was correlated with early relapses. Significantly more relapses were found in tumors with S-phase rates greater than or equal to 20% than among tumors with S-phase rates less than 20% (chi 2 = 9.54, p less than 0.01). A higher relapse rate among tumors with S-phase rates greater than or equal to 20% was found even after taking staging into consideration (Cochran-Mantel-Haenszel test, p less than 0.01). Thus, besides staging, evaluation of the S-phase rate yielded additional prognostic information.
Carcinoma↗