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H Barlebo

Publications and source records attributed to H Barlebo.

17 recordsLinked to original sources
PubMed1991

Treatment of advanced bladder cancer category T2 T3 and T4a. A randomized multicenter study of preoperative irradiation and cystectomy versus radical irradiation and early salvage cystectomy for residual tumor. DAVECA protocol 8201. Danish Vesical Cancer Group.

From 1983 to 1986 183 patients with transitiocellular carcinoma of the urinary bladder, category T2-T4a, entered a randomized study. The patients were allocated to receive either preoperative irradiation (40 Gy) followed by cystectomy or radical irradiation (60 Gy) followed by salvage cystectomy in cases of residual tumor. The two randomization groups were comparable in regard to sex, age, T-categories, tumor size, histological grade and concomitant dysplasia. The two randomization groups included 88 and 95 patients respectively. The treatment plan was followed by 66 patients (75%) in the planned cystectomy group and by 88 (92%) in the radical radiotherapy group of which 27 (28%) were treated with salvage cystectomy. The results showed a trend to a higher survival rate following the combined treatment with preoperative irradiation and cystectomy compared to radical irradiation followed by salvage cystectomy in case of residual tumor, but a statistical significant difference could not be demonstrated. The lack of difference also applied according to the actually given treatment. There was no difference in surgical complications between planned and salvage cystectomy and there were no postoperative deaths among the cystectomized patients. The type of late complications was different in the two treatment groups, but there were no major differences in the number of complications except for the fact that all male patients experienced erective impotence after cystectomy. The T-category, response to radiotherapy and frequency of lymph node metastases were found to be of prognostic importance.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Transitional Cell↗
PubMed1990

[Treatment with low-dose vaginal estradiol in post-menopausal women. A double-blind controlled trial].

Twenty-three postmenopausal women with recurrent cystitis were allorted at random to treatment for five months with local oestrogen in the vagina or placebo treatment with the object of assessing the local effect on the vaginal epithelium and on the tendency to recurrent cystitis. The therapeutic group and the placebo group were entirely comparable prior to treatment. In the therapeutic group, the oestrogen index in vaginal scrapings was significantly higher after treatment than in the placebo group (p less than 0.01). The number of positive urine cultures and the patients/satisfaction with treatment wee not significantly different in the two groups.

Administration, Intravaginal↗
PubMed1990

Histological evaluation of prostatic cancer. (II): Reproducibility of a histological grading system.

The aim of this study was to evaluate the reproducibility, expressed by kappa coefficients, of the histological grading system of prostatic cancer as proposed by Schroeder, Hop, Blom and Mostofi in 1985. This grading system has five prognostic groups based on combinations of growth pattern, mitoses and nuclear anaplasia. All histological slides from 85 cases of prostatic carcinoma were blindly evaluated on two independent occasions by each of four pathologists. The overall INTER-observer agreement and mean INTRA-observer agreement regarding "prognostic group" were 0.55 and 0.69 respectively, whereas the kappa coefficients were 0.38 and 0.57 respectively. An acceptable level of INTER-observer reproducibility of prognostic group I (kappa = 0.70), of the parameter "growth pattern" (kappa = 0.60) and of "slight nuclear anaplasia" (kappa = 0.62) was found. A low overall kappa coefficient of "mitoses" and "nuclear anaplasia" was found. Based on the well reproducible parameters a simplified grading system is proposed.

Anaplasia↗
PubMed1990

Histological evaluation of prostatic cancer. (III): Reproducibility of assessment of tumour volume and its possible significance for prognosis.

The aim of this study was to evaluate the INTER- and INTRA-observer reproducibility of prostatic cancer volume defined as the percentage of chips with carcinoma in transurethrally resected tissue. All histological slides from 80 consecutive cases of prostatic cancer were blindly evaluated on two independent occasions by each of four pathologists. The correlation was expressed by Spearman's rank correlation coefficient (R). Both the overall INTER- and mean INTRA-observer correlation of tumour volume were high with R being respectively 0.905 and 0.918. With reference to stage A1 and A2, data were transformed to an ordinal scale with 2 categories (less than = 5%, greater than 5%). The overall INTER- and mean INTRA-observer agreement of this classification were 0.926 and 0.943 respectively--the corresponding kappa coefficients being 0.68 and 0.74. It is concluded that in transurethrally resected tissue a highly reproducible index of the resected prostatic cancer volume can be given by the percentage of chips with tumour. The prognostic significance of this parameter is discussed.

Humans↗
PubMed1989

Reproducibility of histomorphologic diagnoses with special reference to the kappa statistic.

Systems for classification and grading used in pathology should ideally be biologically meaningful and at least be reproducible from one pathologist to another. A statistical method to evaluate reproducibility (non-chance agreement) for several observers using nominal or ordinal categories has been developed and refined over the past few decades--the kappa statistic. A high level of observed agreement among different pathologists can either signify a high level of reproducibility, if agreement by chance is low, or express a low level of reproducibility, if agreement by chance is almost as high as the observed agreement. Therefore, the observed agreement says nothing in itself, unless it is low. The kappa value, however, indicates how much better the observers are compared to a throw of the dice, and therefore gives the real credit to the agreement which was found. We have developed a user-friendly computer program for calculating inter- and intra-observer agreement of 2 or more observers. By calculating associations between different categories and different observers, the statistic furthermore obtains a function close to the parameter of accuracy. We recommend the use of the above method before a set of nominal or rank scale parameters are used for deciding prognosis and treatment of patients. By submitting a diskette the computer program will be available at no cost.

Histological Techniques↗
PubMed1989

Histological evaluation of prostatic cancer. 1. Reproducibility of tumour type.

It has been claimed that the histological type of prostatic carcinoma bears influence on the prognosis of the patient, and that different treatments have to be considered for different types of tumours. The primary aim of this study was to evaluate the reproducibility of the histological criteria for the ordinary acinic adenocarcinoma and ductal adenocarcinoma. From 85 prospective and consecutive cases of prostatic carcinoma all histological slides were examined on two independent occasions by each of 4 pathologists. The overall inter observer agreement and mean intra observer agreement were 0.69 and 0.74, respectively. The kappa coefficients of these inter and mean intra observer agreements were 0.39 (S.E. = 0.02) and 0.48 (S.E. = 0.08), respectively. Considering a dichotomous classification of pure acinic versus all other types of prostatic carcinoma, an overall inter observer agreement of 0.78 and mean intra observer agreement of 0.84 were found. The kappa coefficients of this dichotomous classification were 0.51 (S.E. = 0.03, inter) and 0.61 (S.E. = 0.11, intra), respectively. It is concluded that the criteria for differentiation between different histological types of prostatic carcinoma need to be improved.

Carcinoma↗
PubMed1986

The Copenhagen bladder cancer project I.

A material of 746 consecutive patients with tumours of the bladder from three hospitals in Greater Copenhagen for the period 1968-1974 is presented. This is the result of The Copenhagen Bladder Cancer Project. Some of the aims of the project were to describe the manifestations of bladder cancer by means of a number of examination parameters. The material may be regarded as representative for the region. About 80 percent of the patients are men, and the mean age is 66 years, but higher for patients with deeply invasive tumours and tumours of low degree of differentiation. Haematuria was the presenting symptom in 84 percent of the patients, and only 3.4 percent had urinary tract infection as sole first symptom. The interval from first symptom to hospitalisation was an average of 7.6 months, but less for cases of deeply invasive tumours and tumours of low degree of differentiation. About 60 percent of all bladder tumours are evaluated as being without invasion of the bladder nusculature, and 59 percent of the tumours are of a high degree of differentiation (Grade 0+I+II). Squamous cell carcinomas are found in about three percent and adenocarcinomas in about one percent of the cases. Benign papillomas, corresponding to Grade 0 tumours, are found in only one percent of the cases. About 50 percent of all transitional cell tumours are both superficial and show a high degree of differentiation. Grade II tumours show invasive growth in at least 25 percent of the cases and Grade III tumours in at least 77 percent. The bladder tumours are papillomatous in 66 percent of the cases, and 24 percent of the patients have more than one tumour in the bladder. Intravenous urography showed a pathological condition in 70 percent of the patients.

Aged↗
PubMed1986

Pathology.

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Histological Techniques↗
PubMed1986

The Copenhagen bladder cancer project II.

The aim of this study has been, on the basis of 746 cases of cancer of the bladder from The Copenhagen Bladder Cancer Project, to assess the prognosis in relation to the tumour classification employed. The following five-year survival rates were found: T1, 59.8 percent, T2, 39.0 percent, T3, 19.7 percent, T4, 5.7 percent. There are significant differences in survival between the different T categories. The survival rates were also calculated for the different histological grades, and significant differences were also found here. Both the T classification and the histological grading are, therefore, relevant prognostic criteria. Papillomatous tumours have the same survival, whether solitary or multiple, but solid tumours have a poorer prognosis than papillomatous tumours. Tumour size is likewise a significant prognostic criterion. Of special interest has been the results of radiotherapy related to the same parameters. Neither the T classification nor the histological grading can be used as prognostic criteria for patients in the present material who were treated by radiotherapy. The overall five-year survival for patients treated by radiotherapy was 22 percent. With the investigative parameters employed, it is not possible in advance to select the group of patients with radiosensitive tumours.

Adenocarcinoma↗
PubMed1972

Ultrasonically-guided liver biopsy.

A method is described of fine-needle aspiration biopsy of liver metastases under direct guidance by ultrasonic scanning. Comparing the results with this technique and those with liver biopsy by Menghini's method in 18 cases, we found that it was more accurate than the usual blind method.

Biopsy↗