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Biomedical subjects

H H Lien

Publications and source records attributed to H H Lien.

At least 55 records · Page 3Linked to original sources
PubMed1989

Chemotherapy of advanced seminoma: clinical significance of radiological findings before and after treatment.

The predictive significance of the mass detected following chemotherapy was assessed in 46 patients with advanced seminoma. Patients with residual viable seminoma in the post-chemotherapy operation specimen or who developed recurrent disease were regarded as chemotherapy failures. This group included 1 of 20 patients in whom the retroperitoneal masses were less than or equal to 10 cm2 3 to 4 weeks after chemotherapy and 4 of 15 patients whose residual masses were greater than 10 cm2. Four of 11 patients with mediastinal tumours achieved a complete remission (mediastinal masses less than or equal to 1 cm2). However, 2 of these 4 patients relapsed, as did 2 of the 4 who achieved a partial remission. In no case was the original size of the tumour significantly related to treatment failure. Three patients had residual lung masses; 1 of these contained histological evidence of viable tumour. In one-third of the irradiated relapse-free patients, slightly enlarged masses were visible on follow-up computed tomography scans taken several years after treatment, even in patients without tumour activity. There is a 25% risk of relapse in patients with advanced seminoma who have retroperitoneal masses greater than 10 cm2 following cisplatin-based chemotherapy. They should be followed up regularly for many years.

Adult↗
PubMed1989

Non-seminomatous testicular cancer clinical stage I: prediction of outcome by histopathological parameters. A multivariate analysis.

The clinical course of 186 orchiectomized patients with testicular non-seminoma clinical stage I (CSI) was reviewed together with a reevaluation of the haematoxylin-eosin-stained histological sections of the primary tumour. Treatment (1970-1980) was as follows: abdominal radiotherapy (group 1): 132 patients; observation only (group 2): 23 patients; retroperitoneal lymph node dissection (group 3): 31 patients. Failure of the management (diagnostic error/relapse after treatment) was defined as demonstration of retroperitoneal lymph node metastases (group 3) or relapse during follow-up (group 2 and 3). Ten of the 31 primarily operated patients had retroperitoneal lymph node metastases. (These patients received 3-4 cycles adjuvant cisplatin based on chemotherapy.) Forty-six patients relapsed after a median time of 6 months (range: 2-113). The 10-year cancer-related survival rates for group 1 and 2 were 85 and 73%, respectively. No cancer-related death occurred in group 3 within the first 5 years. In a univariate analysis the following parameters were significantly (p less than 0.05) correlated with management failure: vascular invasion (blood, lymphatic), the presence of syncytiotrophoblasts, the demonstration of the histological subtype MTU. In a multivariate analysis both lymphatic and blood vessel invasion significantly predicted management failure. In 80% of the non-seminoma patients with CSI and both lymphatic and blood vessels invasion in the primary tumour failure of the primary management must be expected. In the multivariate analysis the demonstration of MTU was a predictive factor only if no differentiation was made between lymphatic and blood vessel invasion. The presence or absence of endodermal sinus tumour was not correlated with the failure rate in non-seminoma CSI. Based on easily assessable histopathological parameters of the primary tumour (small vessel invasion in particular) it is possible to define subgroups of patients with non-seminoma CSI who have a high or a low risk of relapse or who are likely to have microscopic retroperitoneal lymph node metastases. Such a differentiation should have therapeutic consequences.

Humans↗
PubMed1988

A randomized study evaluating radiotherapy versus chemotherapy in patients with inoperable non-small cell lung cancer.

A combination of cisplatin (70 mg/m2 i.v. day one) and etoposide (100 mg/m2 i.v. day one, 200 mg/m2 orally days 2 and 3) repeated every third week to a maximum of 4 cycles were compared with high voltage radiotherapy, 42 Gy given in 15 fractions over a 3-week period to patients with inoperable non-small cell lung cancer (a shield was used in the posterior field to reduce the total spinal dose less than 40 Gy). One hundred and eighteen patients received radiotherapy; the median survival was 10.6 months compared to 10.5 months for the 116 chemotherapy patients (p = 0.81). The objective response rate (CR + PR) was 42% for the radiotherapy and 21% for the chemotherapy group (p = 0.009). At progression it was optional to cross over to the other treatment modality or to receive phase II chemotherapy. Thirty patients primarily treated with radiotherapy and 54 allocated to chemotherapy received second line antineoplastic treatment.

Adult↗
PubMed1988

Late recurrence of testicular cancer.

The aim of this study is to draw attention to important points concerning the clinical management of late relapses in testicular cancer. From 1972 to 1982 The Norwegian Radium Hospital (NRH) has treated 1,008 patients with testicular cancer. Fifteen (1.5%) of these patients relapsed 36 months or more after their primary treatment. The patients' medical records were reviewed in this retrospective study, and all available histological sections were reevaluated. Six patients had pure seminoma initially and relapsed after an average of 54.5 months. Five of them had subjective symptoms due to recurrent tumor. Four patients relapsing in the supradiaphragmatic lymph nodes only are alive with no evidence of disease after an observation time of 17 to 30 months after treatment. Nine nonseminoma patients relapsed after an average of 85 months (36 to 194 months). Eight of these were aware of subjective signs or symptoms due to recurrent tumor leading to the diagnosis of the relapse. Four of these patients are alive with no evidence of disease after an observation time of 4 to 46 months after treatment. Two of these patients relapsed with pure mature teratoma. Late relapses do occur although they are rare events. Seminoma patients relapsing in the lymph nodes only have a good prognosis, and nonseminoma patients have a slightly poorer prognosis. Active follow-up for relapse detection is not justified. All testicular cancer patients should instead be informed of typical signs and symptoms that can be related to a relapse and encouraged to seek medical help for further investigation.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Testicular seminoma: histological findings and their prognostic significance for stage II disease.

Risk factors, their interrelationship, and prognostic relevance for seminoma stage II disease have been examined. The size of the primary tumor was significantly correlated with the pT category, as was the presence of tumor invasion of small vessels. The pT category was correlated neither with clinical substage nor relapse rate. There was a poorer 3-year survival for anaplastic seminomas as compared to that of classical seminomas; the difference was not significant. The 5-year survival for seminomas rich in lymphocytes was better than those of poor lymphocytic infiltration, but this difference also was not significant. No difference in survival or relapse rate was found between HCG-producing and HCG-nonproducing seminomas.

Chorionic Gonadotropin↗
PubMed1987

Intraabdominal hematoma following orchiectomy: a potential pitfall in using CT for staging of testicular cancer.

Internal bleeding in patients undergoing orchiectomy for a malignant testicular tumor can cause a dissecting hematoma in the retroperitoneum. This mass may have the clinical appearance of an iliac fossa mass and may simulate metastasis on computed tomography (CT). This condition was seen in four of 486 orchiectomy patients who underwent postoperative staging with CT. One patient is described in detail.

Diagnosis, Differential↗
PubMed1986

Recombinant interferon alfa-2a with or without vinblastine in metastatic renal cell carcinoma.

Twenty patients with measurable metastatic renal cell carcinoma (RCC) were were treated with interferon alfa-2a (Roferon-A), 36 X 10(6)U intramuscularly 3 times weekly, alone (2 patients) or in combination with vinblastine, 0.10-0.15 mg/kg intravenously every 2 to 3 weeks. Objective responses in the lung, bone, liver, and lymph node metastases were seen in 6 of 18 evaluable patients. Dose reduction of interferon alfa-2a was necessary in 19 of the 20 patients due to intolerable flu-like side effects and fatigue. Bone marrow suppression and increase of gamma-GT represented the most often observed objective toxicity. The preliminary results of this combination treatment in RCC are promising and warrant randomized studies exploring the role of vinblastine. The dose of interferon alfa-2a should be reduced by 50% to avoid excessive toxicity and to maximize patient compliance.

Adult↗
PubMed1985

Sarcoid reaction of hilar and paratracheal lymph nodes in patients treated for testicular cancer.

Bilateral hilar lymph node enlargement developed in four patients 1 to 8 years after successful radiotherapy for testicular cancer Stage I was performed. Two had additional paratracheal involvement. Biopsy showed sarcoid reaction in all four cases. An increased frequency of sarcoid reaction is assumed in patients treated for testicular cancer. The pathogenesis remains unknown. The clinical and radiologic findings should not be misinterpreted as showing recurrent malignant disease. In an otherwise disease-free patient in whom mediastinal lymph node enlargement develops, a biopsy should always be performed.

Adult↗
PubMed1985

Combination chemotherapy of advanced renal cell cancer with CCNU and vinblastine.

No remission was achieved in 15 evaluable patients with measurable metastatic renal cancer treated with CCNU 120 mg/m2 (day 1) and vinblastine 0.1 mg/kg body weight (days 1 and 8) repeated every 6th week. Two additional patients were not evaluable for response owing to early death from progressive disease. Previously reported beneficial response rates in metastatic renal cancer after treatment with CCNU and vinblastine could not be confirmed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Testicular seminoma: analysis of treatment and failure for stage II disease.

Seventy-three patients with seminoma testis stage II have been retrospectively analyzed with regard to prognostic factors and value of prophylactic mediastinal irradiation and chemotherapy. Although survival differences were seen between stage IIa, IIb and IIc, these were not statistically significant. Neither was there a significant difference between IIc patients with tumors greater than 10 cm and less than 10 cm in diameter. The incidence of HCG-producing seminomas in the present series was 16%. No significant difference in survival nor relapse rate was found between HCG-producing and HCG-non-producing seminomas. Prophylactic mediastinal irradiation did not influence the survival nor the relapse rate and may therefore be omitted. In the present series there was no significant improvement neither in relapse rate nor survival in patients receiving pre-irradiation chemotherapy. However, the total number of patients is small and optimal pre-irradiation chemotherapy still have to be defined.

Adult↗
PubMed1984

Carcinoma of maxillary sinus, palate and maxillary gingiva: occurrence of jaw destruction.

A comparison was made between the frequency of alveolar bone-palate destruction caused by carcinomas originating in the maxillary sinus (31 patients), palate (15) and maxillary gingiva (9). Radiographic examination included conventional sinus projections, supplemented with hypocycloid tomography (47), computed tomography (28) and orthopantomography (11). Almost every second tumor presenting with alveolar bone involvement appeared to be a maxillary sinus cancer. Gingival and palatal cancers also caused frequent bone destruction. Radiographic examination, including tomography, was of great value in demonstrating the extent of these tumors. Three cases clinically diagnosed as gingival cancers proved to originate in the maxillary sinus.

Adult↗
PubMed1984

Unilateral retroperitoneal lymph node dissection in patients with non-seminomatous testicular tumor in clinical stage I.

19 of 53 patients (36%) with non-seminomatous testicular cancer, clinical stage I (CS I), had retroperitoneal lymph node metastases, pathological stage II (PS II), demonstrated by retroperitoneal lymph node dissection (RLND). RLND was done unilaterally in peroperatively tumor-free patients (PS I: 34 patients; PS II: 3 patients) and bilaterally if metastatic lymph nodes were found peroperatively. Patients with PS II received adjuvant cis-platinum containing combination chemotherapy. Postoperative tumor activity was observed in 3 patients (median observation time: 31 months). They were cured by salvage chemotherapy. 12-18 months after RLND no ejaculatory disturbances were observed in 28 of 36 unilaterally operated patients. After unilateral RLND, 7 patients fathered children. Unilateral RLND seems to be a sufficient diagnostic procedure in patients with non-seminomatous testicular cancer, CS I, who were found tumor-free during the operation. Fertility is preserved in the majority of the unilaterally operated patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

Comparison of computed tomography, lymphography, and phlebography in 200 consecutive patients with regard to retroperitoneal metastases from testicular tumor.

Two hundred patients with testicular tumor were examined by computed tomography (CT), lymphography, and phlebography of the inferior vena cava and left renal and testicular veins. Metastases were demonstrated in 71. CT was positive in 66, lymphography in 60, phlebography in 53, and a combination of lymphography and phlebography in 65. CT was particularly helpful in studying the upper retroperitoneal space and defining the extent of tumor. Lymphography was preferable for demonstrating metastases in non-enlarged, contrast-filled nodes. Phlebography was never the only positive examination and is not recommended as a routine procedure, though it may be helpful in planning surgery. The authors suggest that CT be performed first, followed by lymphography in negative or equivocal cases.

Adolescent↗