Search PubMed⌕ Search

Biomedical subjects

F Sellner

Publications and source records attributed to F Sellner.

At least 19 recordsLinked to original sources
PubMed1997

Chemotherapy for germ cell tumors relapsing after high-dose chemotherapy and stem cell support: a retrospective multicenter study of the Austrian Study Group on Urologic Oncology.

BACKGROUND: In most patients with advanced refractory germ cell tumors undergoing high-dose chemotherapy with stem cell support (HDCT) the disease progresses after HDCT. This study was designed to shed light on the unestablished role of post-HDCT chemotherapy. PATIENTS AND METHODS: In a retrospective multicenter study data of 47 evaluable patients from nine centers subjected to post-HDCT chemotherapy for progression of their germ cell tumors were collected in a questionnaire survey and analyzed for treatment response and survival. RESULTS: Of 191 patients pretreated by HDCT, 48 (25%) were subjected to post-HDCT chemotherapy for disease progression. Remission was achieved in 17 (36%) and marker-negative remission in eight (17%). The median survival time was 26 weeks, 65 weeks for responders and 13 weeks for non-responders. Only one of 47 evaluable patients achieved sustained complete remission. Remissions significantly correlated with the post-HDCT interval, the use of ifosfamide and the combination regimens of cisplatin + etoposide i.v. or ifosfamide and of paclitaxel + ifosfamide or cisplatin. On univariate analysis a longer post-HDCT interval, the use of cisplatin, paclitaxel and ifosfamide and the combined use of paclitaxel + ifosfamide and/or cisplatin significantly improved the chances of survival. On multivariate analysis only treatment with paclitaxel and ifosfamide retained independent prognostic significance for survival. CONCLUSIONS: One third of the patients considered to be candidates for further chemotherapy once progressive after HDCT went into remission with a gain in survival time. Sustained remissions may occur, but are rarely seen. Paclitaxel and ifosfamide appear to be the most effective drugs in these heavily pretreated patients.

Adult↗
PubMed1996

Adjuvant chemotherapy for high-risk clinical stage I nonseminomatous testicular germ cell cancer: long-term results of a prospective trial.

PURPOSE: To assess the impact of short-term adjuvant chemotherapy on relapse rates, treatment-related morbidity, and long-term toxicity in patients with clinical stage I nonseminomatous testicular germ cell tumor (NSGCT I) who carry a high risk of relapse, ie, who show blood-vessel invasion (VI) by the primary tumor. PATIENTS AND METHODS: From January 1985 to January 1995, 42 NSGCT I patients with VI were treated with two courses of cisplatin, etoposide, and bleomycin (PEB) after orchidectomy. Of these, 29 patients with a follow-up time of more than 2 years are the subject of this report. NSGCT I patients without VI were assigned to a surveillance program and served as controls for the assessment of long-term toxicity. RESULTS: During a median follow-up time of 79 months (range, 27 to 119), two patients relapsed. One developed fully differentiated mature teratoma; the other was a true chemotherapy failure and again developed embryonal carcinoma. Twenty-seven patients (93%) are alive without evidence of disease; one patient (3%) died of progressive testicular cancer and another of lung cancer. The two courses of PEB did not cause any severe acute adverse reactions. The assessment of late sequels of adjuvant chemotherapy based on clinical and laboratory evidence of cardiovascular and pulmonary disease, fertility, and secondary neoplasms, as well as on a psychosocial questionnaire, did not show any significant disadvantages versus the control group. CONCLUSION: Adjuvant chemotherapy with two courses of PEB is an effective and reasonable treatment option for patients with clinical stage I NSGCT who carry a high risk of relapse. No adverse late sequelae were detected within a median follow-up time of more than 6 years.

Adolescent↗
PubMed1993

The importance of tumour volume in the prognosis of radically treated periampullary carcinomas.

OBJECTIVE: To assess the influence of tumour volume on clinicopathological findings and survival time after radical operation for periampullary carcinoma. DESIGN: Retrospective study. SETTING: Kaiser-Franz-Josef-Hospital, Vienna, Austria. SUBJECTS: 72 of 75 consecutive patients who underwent pancreaticoduodenectomy for periampullary carcinoma between 1 January 1979 and 31 December 1991. OUTCOME MEASURES: Cancers were divided into four groups according to volume (mm3) and the incidence of lymph node involvement, infiltration of surrounding tissues and of visceral vessels, and histologically non-radical resections were calculated, as was the length of survival after resection. RESULTS: There were 22 tumours with a volume of 0-2500 mm3 (group 1), 12 with a volume of 2,501-5,000 mm3 (group 2), and 19 each in groups 3 (5,0001-10,000 mm3) and 4 (more than 10,000 mm3). All carcinomas of the common bile duct (n = 5) and the papilla of Vater (n = 18) were in groups 1 and 2, whereas 38 of the 49 carcinomas of the head of pancreas were in groups 3 and 4. Lymph nodes were involved in 3 (14%), 6 (50%), 13 (68%) and 14 (74%); the surrounding tissues were infiltrated in 6 (27%), 8 (67%), 11 (58%) and 12 (63%); the main visceral vessels were involved in 0, 3 (25%), 5 (26%) and 8 (42%); and the resections were histologically not radical in 0, 2 (17%), 7 (37%) and 9 (47%), respectively. There was significant negative correlation (p < 0.0001) between tumour mass and survival. CONCLUSIONS: These results explain at least in part the poorer prognosis after radical resection of carcinoma of the head of the pancreas.

Aged↗
PubMed1990

Investigations on the significance of the adenoma-carcinoma sequence in the small bowel.

In view of the rarity of small-bowel epithelial neoplasms as compared with the case for the large bowel, evidence for an adenoma-carcinoma sequence in the small bowel was studied based on a search for data in the medical literature for the years 1927 through 1986. Sufficiently defined data were found for comparison of 185 benign adenomas, 76 adenoma-with-carcinomas, and 1333 carcinomas in patients without familial polyposis disease and for 63, five, and 30, respectively, in patients with disease. For patients without polyposis, it was found that (1) 29.8% of all small-bowel adenomas (33.6% if those at Vater's ampulla are excluded) showed malignancy; (2) the mean and median ages were lower for benign adenoma than for adenoma-with-carcinoma and carcinoma, although the ratios by sex were the same; (3) there is a nearly identical spatial distribution of the three types of epithelial neoplasms within the small bowel; and (4) both the frequency of finding adenomatous residues existing in continuity with carcinoma and the life history of the adenoma-carcinoma sequence are similar in the small bowel as in the large. In comparing these results with those from patients with familial polyposis disease, it was particularly noted that (1) the only difference was that adenomas in familial polyposis occurred earlier and multiply, and (2) the spatial distributions of adenomas and carcinomas for both cases were closely similar. It is therefore postulated that the adenoma-carcinoma sequence is as significant in the small bowels as in the large. A hypothesis regarding the relationship of epithelial neoplasms in people with and without familial polyposis disease is suggested.

Adenoma↗
PubMed1990

[Correlation of tumor site and tumor volume in radical surgery of cancer of the peripapillary area].

In a group of 52 partial duodenopancreatectomies (34 cancers of the head of the pancreas, 14 cancers of the papilla and 4 cancers of the common bile duct) the dependence of tumour volume and tumour localisation on carcinomatous lymph node involvement, infiltration of surrounding tissues, infiltration of great visceral vessels and not radical resection was determined. The analysis demonstrates that there is significant difference in volume between radically treated carcinomas of the common bile duct, the papilla of Vater and the head of the pancreas with mean volumes of 463:1,851:11,835 mm3 or 1:4:26! Furthermore the investigation shows that for every analysed parameter median volume is larger for positive observations than for negative ones: lymph node involvement 10,606:6,459 mm3, infiltration of surrounding tissues 10,444:6,703 mm3, infiltration of great visceral vessels 14,923:7,144 mm3, not radical resection 18,130:5,343 mm3. From these results it is concluded, that early stages of periampullary carcinomas with a good chance for cure are only present in radically treated cancers of the papilla and the common bile duct. In cancers of the head of the pancreas the significant larger primary cancers and the more advanced staging results in a dismal prognosis.

Ampulla of Vater↗
PubMed1989

[Change in the value of palliative interventions in cancer of the head of the pancreas].

An analysis of 412 patients with carcinoma of the head of the pancreas treated only with palliative procedures revealed remarkable differences in the results following internal anastomosis procedures and external T-tube drainage. The anastomosis group showed in comparing the years 1963-1982 with the years 1983-1987 a decline in the frequency of such procedures from 89% to 54% and a decline of the mortality from 12% to 4% while the survival time (220 days) showed no change. According to the low mortality rate we prefer internal anastomosis procedures to PTCD. However, as the results of T-tube drainage are still poor (mortality rate 36%; survival time 190 days) an attempt of PTCD seems indicated if the untreatable situation is recognized preoperative, as PTCD achieves similar results as T-tube drainage.

Aged↗
PubMed1987

[Hypothesis on the existence of an adenoma-carcinoma sequence in the small intestine].

An analysis of a literature survey of 104 adenomas of the ampulla of Vater, 94 of the duodenum and 20 of the jejunum and ileum, as well as 735 carcinomas of Vater's ampulla, 180 carcinomas of the duodenum and 72 carcinomas of the jejunum and ileum, demonstrated, in spite of small case collectives, that there is probably a similar close relationship between adenomas and carcinomas in the small intestine, as in the large intestine. In adenomas of the small intestine signs of malignancy sometimes can be seen, as well as in some case of carcinoma of the small intestine rests of adenomas have been described. The age and sex distribution of the epithelial neoplasms of the small intestine permits an adenoma-carcinoma-sequence. The relative distribution of the adenomas over the different parts of the small intestine corresponds with that of the carcinomas. The adenomas and carcinomas of the small intestine in patients with adenomatosis coli have the same relationship to the neoplasms of the small intestine in patients without adenomatosis coli, as it is valid in the large intestine. The hypothesis of an adenoma-carcinoma-sequence in the small bowel with a great significance, which explains the results best, is therefore proposed. As the distribution of adenomas and carcinomas of the small bowel in patients with and without familial polyposis is equal, the theory is suggested, that the principle of the adenomatosis intestine disease is a general increase of the overall liability to adenomas in the large and small intestine.

Adenomatous Polyposis Coli↗
PubMed1986

[Development of carcinoma of Vater's ampulla in an adenoma. Analysis of a personal case load and review of the literature].

A retrospective analysis was undertaken of our case material of 40 histological preparations of carcinoma of the ampulla of Vater, as well as a survey of the literature of 103 adenomas of the ampulla of Vater. Signs of malignant transformation were detected in 25% of the adenomas, whilst adenomatous residues were identified in 72% of the examined carcinomas of the ampulla of Vater. Thus, an adenoma-carcinoma sequence seems to be as significant in the case of Vater's papilla as in the colo-rectal region. An epidemiological investigation confirms this hypothesis since 1. adenomas of the papilla Vateri develop 4 years prior to a carcinoma and 2. the relative sex distribution of the two diseases is approximately equal.

Adenoma↗
PubMed1986

[Adenomas and carcinomas of the small intestine in familial polyposis and Gardner syndrome--analysis of a literature survey].

An analysis of 70 case records from the literature of patients with familial polyposis or Gardner syndrome and adenomas or carcinomas of the small bowel demonstrated that there is no difference between the neoplasms of the small bowel in familial polyposis or in Gardner syndrome. Between the adenomas and the carcinomas of the small bowel it was possible to show, that there exists a similar close relation as in the large intestine. In some carcinomas of the small bowel rests of adenomas can be observed. The peak incidence of small bowel adenomas is more than a decade earlier than that of carcinomas. The distribution of adenomas in the small bowel is quite similar to that of carcinomas. Therefore it can be supposed, that the significance of familial polyposis coli and Gardner syndrome for the importance of an adenoma-carcinoma-sequence in the large bowel is also existing in the small bowel.

Adenomatous Polyposis Coli↗
PubMed1984

[Changes in the value of papilla excision in papilla cancer. A retrospective study].

A retrospective analysis of 56 patients with a carcinoma of Vater's ampulla in the years 1956-1983 demonstrated a steadily increasing resection index of duodenopancreatectomy from 34% (1961-1965) to 86% (1981-1983), although the rate of mortality was 0% since 1975. The reason for the increasing resection index was the treatment of all patients since 1975 by only one team of operators and the improvement of peri- and postoperative medicine treatment. Thus it was possible to perform a duodenopancreatectomy without operative mortality even in patients in the 8th decade of life. Therefore an indication for a local excision of the ampulla no longer seems to be justified.

Adult↗
PubMed1983

[Primary gallbladder cancer].

118 surgically-treated patients with gall bladder carcinoma and 407 autopsies recording this diagnosis were reviewed and analysed with a view to investigating the reasons for the bad prognosis of this disease. An early tumour stage was seen in only 5.9% of the surgical patients. A possible reason for the bad results even at an early tumour stage is undertreatment by simple cholecystectomy. In advanced stages of gall bladder carcinoma palliative operations have a better prognosis than diagnostic laparotomies. Prevention of gall bladder carcinoma through prophylactic cholecystectomy in the case of documented lithiasis failed to prevent gall bladder carcinoma in our group of patients because only 9% of the patients with gall bladder carcinoma had been diagnosed as having lithiasis in time to consider cholecystectomy as a preventive measure.

Cholelithiasis↗
PubMed1983

[Incidence of fatal, biliary pancreatitis--an analysis of 19167 autopsy protocols].

19 167 autopsy records are analysed to the frequency and to risk-groups for a lethal biliary pancreatitis. In cholecystolithiasis biliary pancreatitis was the far most stone caused lethal complication, in choledocholithiasis the 4. An increased incidence of the lethal biliary pancreatitis was found in younger individuals, in male individuals and in choledocholithiasis.

Adolescent↗
PubMed1982

[Factors influencing the survival time of patients subjected to "radical" surgery for cancer of the papilla of Vater (author's transl)].

17 patients who were treated by partial pancreato-duodenectomy for cancer of the ampulla of Vater were reviewed to see if intermittent jaundice, the staging of the carcinoma, the grading of the carcinoma and the presence of regional lymph node metastases had any influence on the survival time. There were markedly longer survival times for patients with intermittent jaundice, high grading, low staging and absence of regional lymph node involvement.

Adult↗
PubMed1982

[Carcinoma of the gallbladder unexpectedly diagnosed after cholecystectomy for lithiasis (author's transl)].

Patients with clinically apparent carcinoma of the gallbladder seldom survive 5 years. This is only seen in about 20% of the patients whose gallbladder carcinoma is unexpectedly first discovered by the pathologist after a routine cholecystectomy for lithiasis. The prognosis of this seldom seen early stage of carcinoma of the gallbladder, which is applicable to only 10-23% of all gallbladder carcinomas, is strongly dependent on the penetration of the tumor in the wall of the gallbladder. Of the patients with a carcinoma infiltrating only the mucosa of the gallbladder, 60% can be cured for 5 years by a simple cholecystectomy, whereas for more advanced cancers this procedure seem to be inadequate. In these stages a relaparotomy should be considered with an addition wedge resection of the liver and a regional lymphadenectomy.

Aged↗
PubMed1981

[Quality of life after duodenopancreatectomy in patients with carcinoma of Vater's ampulla (author's transl)].

Partial duodenopancreatectomy, which leads to poor long-term results in the treatment of cancer of the head of the pancreas, achieves 5 years survival rates of 30% in cancer of Vater's ampulla. A report is given on 3 patients, who could be cured of a cancer of Vater's ampulla by this procedure for more than 10 or 15 years respectively. The quality of life of these patients is satisfactory. As a late consequence diabetes mellitus occurred in 2 patients.

Adenocarcinoma↗
PubMed1981

[A proposal for staging and grading of carcinomas of the papilla of Vater (author's transl)].

Reviewing 28 carcinomas of the papilla of vater from the material of our department, an attempt was made to develop a staging and grading system oriented along the lines of WHO recommendations and largely integrates Dukes findings. The staging system provides for 3 stages, i.e. A. B. and C. for grading, 3 degrees of malignancy, i.e. g1. G2. and G3. are distinguished. These, in turn, are based on 3 criteria : histological dedifferentiation, cytological dedifferentiation, and the number of mitoses. In the 14 patients with low-stage (stage A) and low-grade (grade G1) cancer life expectancy was excellent ; indeed it was significantly better (p less than 0.05) than in the other 2 groups.

Adenocarcinoma↗