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Biomedical subjects

B Patsner

Publications and source records attributed to B Patsner.

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

The value of CT scanning in the management of patients with gynecologic malignancies.

The management of gynecologic malignancies is exceedingly complex, requiring thoughtful coordination of surgery, radiation therapy and chemotherapy. Despite the fact that the natural history and clinical course of these cancers are generally well understood, the scarring caused by surgery and/or radiation, and the marked limitations of pelvic examination make clinical staging and evaluation of limited value and known inaccuracy in following women with ovarian, cervical, uterine, vulvar and vaginal cancers. Understandably, the development of computerized axial tomography (CT), and its ability to visualize the abdomen and pelvis, lead to rapid acceptance of CT scans in defining extent of cancer and following patient response to various therapeutic interventions (Chen et al. 1980; Feigen et al. 1987; Photopoulos et al. 1977). Authors have compared the accuracy of CT findings with physical examination, surgical findings, lymphography, conventional radiography or ultrasound (Clarke-Pearson et al. 1986; Vercamb et al. 1987; Amendola 1981; Kerr-Wilson et al. 1984). However, little has been written on the effect of CT scanning on patient management. If we define and accept the accuracy of CT scanning in detecting pelvic and abdominal disease, can we show a benefit in patient management? Or, does CT scanning provide us with expensive information, or misinformation, which fails to translate into better patient care. Do complex imaging modalities compliment thorough examination and experienced clinical judgement, or only duplicate findings and provide extraneous information? To answer these questions, eighty-one months experience in using CT scanning in managing patients with gynecologic malignancies was reviewed.

Biopsy↗
PubMed1989

Serum squamous cell carcinoma antigen levels in patients with invasive squamous vulvar and vaginal cancer: a preliminary report.

Pretreatment serum squamous cell carcinoma antigen (SCC) levels were obtained in 12 patients with invasive vulvar and 5 patients with invasive vaginal squamous cancer. Only 4 of 12 (33%) patients with vulvar cancer and 1 of 5 (20%) patients with vaginal cancer, usually those with more advanced disease, had elevated serum SCC levels at the time of diagnosis.

Aged↗
PubMed1989

Management of lymphocysts after radical gynecologic surgery.

Pelvic lymphocysts developed in 3 of 124 patients undergoing radical surgery for cervical cancer. All were managed by percutaneous aspiration under local anesthesia in an outpatient setting. Sclerosis was required in one patient. This management plan is superior to laparotomy in being less morbid and equally effective.

Adenocarcinoma↗
PubMed1989

Doxorubicin delivered by subcutaneous pellets suppresses uterine sarcoma xerografts in athymic mice.

An in vivo model system has been developed to test the sensitivity of human malignancies xerotransplanted into athymic mice for sensitivity to a chemotherapeutic agent, delivered by subcutaneously placed, slow-release pellets. Pellets were specially created to release set amounts of doxorubicin (DX). BALB/c nude mice were injected with equal aliquots of minced human mixed mullerian sarcoma (MMS) of the uterus and divided into groups: control and DX-treated (750 micrograms/day). The tumor growth rate in the DX-treated group of mice was significantly reduced when compared to controls in two experiments, 1 (P less than 0.001) and 2 (P less than 0.01). Final tumor weight was also significantly less in the DX-treated group (P less than 0.001). This model system, utilizing pellet delivery of chemotherapy to human malignancies heterotransplanted into athymic mice, may be an effective means of screening the activity of anticancer agents on human tumors, avoiding more cumbersome drug administration methods.

Animals↗
PubMed1989

Cholecystectomy accompanying major abdominal surgery for gynecologic cancer.

In a 66-month period 950 major abdominal operations were performed for known or suspected gynecologic malignancy. Thirty-five patients (3.6%), of whom 29 had proven gynecologic malignancy, underwent cholecystectomy for cholelithiasis known from prior evaluation or found incidentally during abdominal exploration. All cholecystectomies were performed through the original incision with no direct operative morbidity or mortality. Cholecystectomy accompanying gynecologic cancer surgery appears to be well tolerated if performed expeditiously, and avoids the potential of postoperative cholecystitis in this select group of patients.

Adult↗
PubMed1989

Use of serum CA-125 levels to monitor therapy of patients with advanced or recurrent endometrial carcinoma.

Serial serum CA-125 levels were measured in fifteen patients with recurrent or advanced endometrial carcinoma during treatment with chemo- or hormonal therapy. All patients had measurable disease by physical examination, chest X-ray or CT scan. Serum CA-125 levels were invariably elevated, and generally reflected, response to therapy in all patients with intraperitoneal or pulmonary metastases. Levels were normal in two of three patients with isolated vaginal metastases prior to and following response to progesterone.

Adenocarcinoma↗
PubMed1989

Does preoperative serum squamous cell carcinoma antigen level predict occult extracervical disease in patients with stage Ib invasive squamous cell carcinoma of the cervix?

Preoperative serum squamous cell carcinoma antigen levels were obtained from 65 patients with International Federation of Gynecology and Obstetrics stage Ib invasive squamous cervical cancer before planned radical hysterectomy to determine whether elevated squamous cell carcinoma antigen levels (greater than 2.5 ng/mL) predicted occult extracervical extension of disease. Although the specificity of a normal level was good (0.91), the sensitivity of an elevated level was only 0.68. Not all patients with nodal metastases had elevated serum squamous cell carcinoma antigen levels; in particular, no patient with occult para-aortic nodal disease had elevated serum squamous cell carcinoma antigen.

Antigens, Neoplasm↗
PubMed1988

Use of serum CA-125 in monitoring patients with uterine sarcoma. A preliminary report.

Elevated preoperative serum CA-125 levels were present in three of four patients (75%) with Stage I uterine sarcoma found to have extrauterine spread of disease at laparotomy as well as five of seven (71%) patients with clinically advanced and recurrent uterine sarcoma. Serial levels during chemotherapy inconsistently reflected response to treatment and proved to have limited clinical value.

Antigens, Neoplasm↗
PubMed1988

Preoperative serum CA-125 levels in patients with surgical stage I invasive ovarian adenocarcinoma.

Preoperative serum CA-125 levels were elevated in only three of 13 patients (23%) with a pelvic mass who were found to have surgical stage I invasive ovarian adenocarcinoma. This low incidence is surprising, since elevated levels have been found in greater than 80% of patients with advanced ovarian cancer. This suggests serious limitations for using serum CA-125 levels as a screening test for ovarian cancer.

Adenocarcinoma↗
PubMed1988

Herpetiform cutaneous metastases following negative second look laparatomy for ovarian adenocarcinoma.

Cutaneous metastases from gynecologic malignancy are rarely reported, and when present are invariably accompanied by intraperitoneal disease. In the present case extensive metastases to the skin of the abdomen, groin, thigh and perineum appeared six weeks following extensive "second look" laparotomy which revealed no evidence of intraperitoneal or retroperitoneal disease. The appearance of cutaneous metastases was preceded by only a one month history of leg swelling, erythema, and a markedly elevated serum CA-125. Problems in the differential diagnosis and management of this clinical situation are discussed.

Abdomen↗
PubMed1988

Radical vulvectomy and "sneak" superficial inguinal lymphadenectomy with a single elliptic incision.

With a single elliptic radical vulvectomy incision, resection of the primary tumor and bilateral superficial inguinal lymphadenectomies were performed in 18 patients with invasive squamous cell carcinoma of the vulva. Twelve patients (67%) had no morbidity from the procedure, while five patients (28%) developed significant wound breakdown and one patient (5%) developed a groin hematoma. For select patients with invasive vulvar cancer, this modification of the standard "butterfly" incision offers an acceptable surgical approach to this disease, allowing removal of the primary lesion and adequate sampling of the groin lymphatics. Results of pathologic examinations allow selection of those patients requiring further therapy.

Aged↗
PubMed1988

Predictive value of preoperative serum CA 125 levels in clinically localized and advanced endometrial carcinoma.

Serum CA 125 levels were measured preoperatively by standard radioimmunometric techniques in 89 patients with primary endometrial carcinoma before definitive surgical staging and resection. Fifty-seven of 58 (98%) patients with clinical and surgical Stage I or II disease had normal preoperative serum CA 125 levels. All eight patients with clinically advanced endometrial cancer (International Federation of Gynecology and Obstetrics Stage III or IV) had elevated CA 125 levels before surgery. Twenty of 23 patients (87%) with clinical Stage I or II endometrial cancer who were found to have extrauterine spread of disease during staging laparotomy had elevated preoperative serum CA 125 levels. Thus preoperative CA 125 levels were elevated in 28 of 31 patients (90.3%) with surgically staged endometrial adenocarcinoma with extrauterine disease and may play a useful role in detecting those patients with clinically localized endometrial cancer who have occult extrauterine spread of disease.

Adenocarcinoma↗