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Biomedical subjects

C A Hubay

Publications and source records attributed to C A Hubay.

At least 37 records · Page 2Linked to original sources
PubMed1982

Estrogen receptor status as a prognostic indicator for stage I breast cancer patients.

The prognostic value of estrogen receptor determination was studied for 510 stage I (axillary node negative) breast cancer patients treated by mastectomy alone. Results at 60 months after mastectomy indicate that stage I patients whose tumors lack estrogen receptors fall into a significantly poorer prognostic group for both recurrence and survival than those whose tumors contain estrogen receptors. Within the postmenopausal group, estrogen receptor negative (ER -) patients are recurring more rapidly than estrogen receptor positive (ER +) patients. Within the premenopausal group, ER + patients have a recurrence rate identical to ER - patients, which is apparent only after prolonged follow-up. In contrast to postmenopausal ER + patients, premenopausal ER + patients appear to have no prognostic advantage over the ER - patients, and thus constitute a high risk group for which adjuvant endocrine therapy might prove beneficial.

Breast Neoplasms↗
PubMed1981

Adjuvant therapy of stage II breast cancer: 48-month follow-up of a prospective randomized clinical trial.

A prospective, randomized clinical trial of adjuvant treatment of 318 stage II breast cancer patients, using chemotherapy, the antiestrogen tamoxifen, and immunotherapy is reported at 48 months follow-up. Women whose primary tumors have no estrogen receptors fall into a significantly poorer prognostic group than those whose tumors contain estrogen receptors. None of the adjuvant regimens appeared to offer any clear-cut advantage for the estrogen receptor negative patients. Those women whose primary tumor contains estrogen receptors appear to be in a prognostically favorable group, when their treatment regimen included the antiestrogen, tamoxifen. The adjuvant use of BCG immunotherapy does not appear to offer additional benefit, but the follow-up period of these treated patients is too brief to be conclusive. A longer period of observation is needed to determine whether this systemic treatment in estrogen receptor positive patients is preventing recurrence or merely delaying it.

Antineoplastic Agents↗
PubMed1980

Adjuvant chemotherapy, antiestrogen therapy and immunotherapy for stage II breast cancer: 45-month follow-up of a prospective, randomized clinical trial.

The results of adjuvant chemotherapy (CMF), endocrine therapy (t), and immunotherapy (BCG) in 318 women who had undergone mastectomy for Stage II breast cancer are reported after 45 months of life table analysis. CMFT therapy was found to be more effective than CMF alone in increasing recurrence-free survival. This beneficial effect appears to be limited to patients with estrogen receptor-positive tumors (ER+). Patients with estrogen receptor-negative tumors (ER-) (< 3 fmol/mg) have increased recurrence rates and higher mortality.

Antineoplastic Agents↗
PubMed1980

Antiestrogen, cytotoxic chemotherapy, and bacillus Calmette-Guerin vaccination in stage II breast cancer: a preliminary report.

A prospective, randomized clinical trial of three treatment regimens: (1) Cytoxan, methotrexate, and 5-fluorouracil (CMF), (2) CMF plus the antiestrogen drug, tamoxifen (CMFT), and (3) CMFT plus bacillus Calmette-Guerin (BCG) vaccinations in women with stage 22 breast cancer is reported. All patients underwent mastectomy and estrogen receptor (ER) analysis was performed. The results of this study show that patients with ER- tumors have recurrences more rapidly and have a higher mortality rate than patients with ER+ tumors (P less than 0.0001). In ER+ patients CMFT treatment is more effective in delaying recurrence than CMF alone at 33 months (P = 0.0176). This effect appears to be occurring in both premenopausal and postmenopausal women. In ER- patients the recurrence rate is high, and there is no significant difference among the three treatment groups. In premenopausal patients treated with CMF alone, however, ER- patients recur more rapidly than ER+ patients (P = 0.0313) and suggests that the effect of CMF may be related to the suppression of ovarian function. These findings have demonstrated a significant role for the use of antiestrogen therapy in patients with state II, ER+ breast cancer.

Actuarial Analysis↗
PubMed1978

Pregnancy and breast cancer.

Breast cancer in association with pregnancy and lactation is rare, but presents a therapeutic problem of considerable magnitude. The outlook for such patients is less favorable than that of nonpregnant, nonlactating women, probably because the stage of the disease is more advanced when it is discovered. The most significant factor in the poorer prognosis is physician delay in diagnosis and therapy. When mastectomy is carried out early in pregnancy, the operation can be as effective as in nonpregnant women of the same age groups. It is emphasized that when pregnancy and breast cancer are found concurrently, prompt therapy for the cancer should be undertaken. Interruption of pregnancy in nondisseminated breast cancer is of little value. If pregnancy is near term when the diagnosis of disseminated breast cancer is made, the desire of the husband and wife for a child should be considered. A modest delay in therapy to allow for delivery probably has no deleterious effect. Castration should be withheld and used only for the patient with metastatic disease. There may be a place for prophylactic castration in the treatment of disseminated disease, but its role is yet to be clearly defined. Subsequent pregnancies in a patient with axillary spread at the time of mastectomy are contraindicated, because of the high rate of treatment failure and decreased rate of survival. In patients desiring future pregnancies following mastectomy, a period of observation of at least 2 years seems wise. At the end of that period, if clinical evaluation, laboratory values, roentgenographic studies, and isotopic bone scanning are negative for disseminated disease, subsequent pregnancies seem safe. Prompt evaluation of any breast mass found during pregnancy and lactation should be carried out by needle or operative biopsies under local anesthesia. Although the prognosis of the pregnant or lactating woman with breast cancer is generally favorable, numerous long-term survivals are encountered in those women who undergo prompt mastectomy early in pregnancy. The former pessimistic outlook for such patients seems unjustified. With modern methods of diagnosis and treatment, therapy can be effective and successful.

Abortion, Therapeutic↗
PubMed1977

Peripheral ischemia due to retroperitoneal fibrosis.

Two patients with retroperitoneal fibrosis demonstrated symptoms of peripheral vascular ischemia. Arteriolysis to free the distal aorta and iliac vessels was successful in both patients. Aortography in the posteroanterior view was equivocal, but the accompanying urologic abnormalities and a history of methysergide ingestion helped establish the etiology of the ischemia. The most direct approach to the treatment of the vascular obstruction caused by retroperitoneal fibrosis is complete arteriolysis. Most previous reports indicate that it is relatively easy to establish a dissection plane between the fibrotic plaque and the vessel wall. We found that the fibrotic process invaded the vessel wall. Accordingly, the surgeon must anticipate a difficult, tedious dissection when performing arteriolysis for the treatment of vascular compression secondary to retroperitoneal fibrosis.

Female↗
PubMed1977

Gilt by association.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMed1975

Specific responsiveness of leukocytes to soluble extracts of human tumors.

The leukocyte adherence inhibition (LAI) method was studied with respect to its specificity in detecting responses to extracts of tumor tissues or normal lymphocytes. Responses of cells from normal persons were within 10% of each other whether incubation was carried out with culture medium alone or with any of the extracts. The same was true of cells from 78 cancer patients unless the cells were incubated with extracts of the same histologic type as their own. In the latter case, statistically significant responses occurred in 95% of the 110 analyses done. Negative responses were given by cells from 14 patients tentatively diagnosed as having breast carcinoma but whose lesions later proved benign. There was one positive response inconsistent with the diagnosis. Of 29 normal individuals known to have been exposed to tumors or tumor extracts, 11 responded positively and specifically to the relevant tumor extract. Cells from 12 of 30 multiparous female breast-cancer patients responded to extracts of pooled normal lymphocytes. The results establish that the LAI analysis is an extremely specific means of detecting systemic responses to malignant diseases. In addition, analyses have proven positive in 95% of the cases studied.

Antigens, Neoplasm↗
PubMed1975

Occult adrenal insufficiency in surgical patients.

Eight patients admitted to a University hospital with acute surgical problems and related adrenal insufficiency were reviewed and three are presented in detail. Surgical stress and continued sepsis played major roles in the lack of responsiveness to usual modes of therapy until the adrenal insufficiency was corrected. The patients fell into three major clinical categories of adrenal insufficiency. Chronic illness and sepsis are shown to affect steroid production and metabolism, as well as adrenal responsiveness to ACTH. Pharmacologic amounts of steroids are often needed in patients with shock, gram negative sepsis and prolonged illnesses, even if normal or elevated serum cortisols are present. Therapeutic trials of cortisol administration are shown to be confusing when not accompanied by easily performed diagnostic tests of adrenal function. It is emphasized that a pretreatment serum cortisol should be obtained whenever possible. The evaluation of adrenal function is of lifelong importance to the patient.

Acute Disease↗