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Biomedical subjects

H Pickel

Publications and source records attributed to H Pickel.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Hormone substitution in patients after primary treatment of gynecologic malignancies].

Hormone replacement therapy for postmenopausal patients following primary treatment of gynecologic malignancies has changed considerably during recent years. Estrogens have been found useful to prevent osteoporosis and cardiovascular disease as well as to ameliorate symptoms of estrogen deprivation. Thus, hormone replacement therapy can improve life quality of patients. Estrogen-gestagen replacement therapy after primary treatment of endometrial cancer is no longer contraindicated, at least in stage Ia to Ib disease. For breast cancer patients, the German Society of Senology has published recommendations based on the receptor status and lymph node status of an individual patient. Exogenous estrogens and gestagens are not contraindicated for breast cancer patients with negative receptors and negative lymph nodes. However, tamoxifen is indicated for patients with positive receptors and positive lymph nodes. If symptoms of hormonal deprivation occur, gestagens may be added to tamoxifen in these patients. There are no contraindications for hormone replacement therapy in patients with malignant tumors of the ovary, fallopian tube, cervix, vagina, and vulva.

Adult↗
PubMed1992

Malignant paraganglioma of the uterus.

We report a malignant uterine paraganglioma in a 40-year-old female, who died 7 months after the initial diagnosis. On light microscopy the tumour showed a typical zellballen pattern as well as a pronounced cellular pleomorphism. In many tumour cells hyaline globules were demonstrated within the cytoplasm. Immunohistochemically the lesion was characterized by the presence of neuron-specific enolase, protein gene product 9.5 and synaptophysin, and electron microscopically by the occurrence of neurosecretory granules.

Adult↗
PubMed1992

Nongenital cancers metastatic to the ovary.

We review our experience with 82 patients with nongenital cancers metastatic to the ovary. All patients were referred for evaluation of an ovarian mass. The patients had primary carcinoma of the breast (n = 28), colon (n = 23), stomach (n = 22), pancreas (n = 7), or gallbladder (n = 2). The overall actuarial 5-year survival rate was 10%. Five-year survival in patients with metastatic colon cancer was significantly higher (23%) than that in patients with metastatic cancer of the breast, stomach, gallbladder, or pancreas, all of whom died within 58 months (P less than 0.05). Patients with unilateral metastatic ovarian involvement had a 5-year survival significantly better than that of those with bilateral involvement (28% vs 5%; p = 0.003). Five-year survival in patients with disease limited to the pelvis was significantly higher than that in those with abdominal spread (22% vs 6%; P less than 0.04). The 5-year survival of patients with residual disease less than 2 cm or greater than 2 cm in diameter was 18% or 4%, respectively (P = 0.002). This pattern applied mainly to differences in patients with primary cancer of the breast or colon (P less than 0.008). These data suggest that an aggressive surgical effort seems to be indicated in colon cancer metastatic to the ovary, as some of these patients may survive 5 years.

Breast Neoplasms↗
PubMed1992

[Primary, papillary serous carcinoma of the peritoneum; a report of experiences].

A total of fourteen patients with primary papillary serous carcinoma of the peritoneum (PPSCP) were treated at the Department of Obstetrics and Gynaecology of the University of Graz between 1980 and 1991. The presence of tumours from other sites, particularly the pancreas and the ovary, had been excluded. Due to extensive spreading of the disease mainly in the upper abdomen, only seven of the 14 patients underwent exploratory laparotomy. The median overall survival time was 10 months (range, 1-28 months). These results are due to the extent of spreading of the disease at diagnosis, and also to the fact, that optimal cytoreductive surgery was possible only in four of the 14 patients. The four patients with optimal cytoreduction showed a better survival than those, who underwent less radical surgery. These results seem to indicate, that, as in primary ovarian cancer, the amount of residual disease may be an important prognostic determining factor in PPSCP.

Adult↗
PubMed1992

Remission induction with carboplatin-epirubicin-prednimustine followed by consolidation radiotherapy in advanced ovarian cancer.

Adjuvant chemoradiotherapy was administered to 26 patients with stage Ic-IV ovarian cancer after radical cytoreductive surgery. All patients received six cycles of carboplatin, epirubicin, and prednimustine and had no clinical evidence of disease after completion of chemotherapy. They received whole-abdominal radiation and radiation to the retroperitoneal lymph nodes. This protocol was discontinued for five (23%) patients because of myelosuppression, progressive disease, or withdrawal. One patient had a small bowel obstruction due to intraperitoneal adhesions. The survival of ten stage-III ovarian cancer patients, who received chemoradiotherapy and were evaluable for assessment of treatment efficacy, was retrospectively compared with the survival of 11 stage-III patients who received chemotherapy only. At 36 months, a slight advantage of the chemoradiotherapy versus the chemotherapy-only group was observed (p = 0.11). These preliminary results suggest that adjuvant chemoradiotherapy may prolong the "no evidence of disease" interval of radically operated ovarian cancer patients. Toxicity is acceptable when second-look surgery is avoided and when subsequent radiotherapy is limited to patients with no evidence of disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

[Psychosexual behavior as a risk factor for cervix cancer].

Seventy-two patients with cervical cancer (n = 24), ovarian cancer (n = 24), or no disease (n = 24) were questioned about sexual activity and personal relationships. The interviews were conducted in a semistandardized fashion according to the Tübingen Sexual Therapy Scale. Patients with invasive cervical cancer did not have a larger number of sexual partners, an earlier age of first intercourse, greater sexual activity or less stable relationships than patients with ovarian cancer of healthy women. There was no statistical difference among the groups with regard to the relationships. However, patients with cervical cancer reported greater degrees of satisfaction with both sexuality and relationships.

Adult↗
PubMed1991

Microinvasive carcinoma of the uterine cervix (International Federation of Gynecology and Obstetrics Stage IA).

In 1985 the International Federation of Gynecology and Obstetrics (FIGO) subdivided Stage IA cervical cancer and specified metric criteria to demarcate Stage IA from Stage IB. Early stromal invasion (Stage IA1) denotes the first invasive protrusions of a carcinoma in situ into the stroma. Microcarcinomas (Stage IA2) are small cancers a number of orders of magnitude larger than Stage IA1 lesions and with a maximum depth of invasion of 5 mm and a maximum horizontal spread of 7 mm; larger lesions are classified as Stage IB. This study reviews 486 patients previously classified as having Stage IA disease. This yielded 344 Stage IA1 and 101 Stage IA2 lesions; 41 cancers were reclassified as Stage IB. Three hundred nine, 89, and 38 patients were followed for greater than or equal to 5 years. One (0.3%) patient with Stage IA1 disease re-presented with Stage IIB disease 12 years after conization. Five (5.6%) patients with Stage IA2 lesions developed invasive recurrences; three died. None of the 38 patients reclassified as having a Stage IB lesion, including 16 who were treated conservatively, developed a recurrence. The FIGO classification is not a guideline for treatment. Stage IA1 lesions can be treated conservatively, but treatment in Stage IA2 must be individualized. Risk factors such as vascular space involvement and confluency are of high sensitivity but low specificity.

Carcinoma↗
PubMed1991

Pretherapeutic scalene lymph node biopsy in ovarian cancer.

To study scalene lymph node involvement in ovarian cancer, 37 patients with this disease underwent pretherapeutic open sampling of the left scalene fat tissue. Only 1 patient had a palpable supraclavicular mass. Positive scalene nodes were found in 7 (22%) of 32 patients with stage III or IV disease. Three of four patients with positive scalene nodes also had both positive pelvic and positive paraaortic nodes; one patient with stage IV disease had negative pelvic and paraaortic nodes. Demonstration of scalene node involvement per se currently does not alter the management of patients with ovarian cancer, although patients with occult involvement of the scalene nodes could be considered ineligible for intraperitoneal chemotherapy.

Adult↗
PubMed1991

Consolidation radiotherapy following carboplatin-based chemotherapy in radically operated advanced ovarian cancer. A pilot study.

Adjuvant chemoradiotherapy was administered to 26 patients with stage Ic-IV ovarian cancer after radical cytoreductive surgery. All patients received six cycles of carboplatin, epirubicin, and prednimustine and had no evidence of disease after completion of chemotherapy. They received whole-abdominal radiation and radiation to the retroperitoneal lymph nodes. Five (23%) of the patients were discontinued on this protocol because of myelosuppression, progressive disease, or withdrawal. One patient had a small bowel obstruction due to intraperitoneal adhesions. The survival of 10 Stage III ovarian cancer patients who received chemoradiotherapy and were evaluable for assessment of treatment efficacy was retrospectively compared with the survival of 11 Stage III patients who received chemotherapy only. At 36 months, a slight advantage of the chemoradiotherapy versus the chemotherapy-only group was observed (p = 0.11). These preliminary results suggest that adjuvant chemoradiotherapy may prolong the "no evidence of disease" interval of radically operated ovarian cancer patients. Toxicity is acceptable when second-look surgery is avoided and when subsequent radiotherapy is limited to patients with no clinical evidence of disease.

Antineoplastic Combined Chemotherapy Protocols↗