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Biomedical subjects

H Salzer

Publications and source records attributed to H Salzer.

At least 73 records · Page 4Linked to original sources
PubMed1989

The value of second-look operation in patients with advanced epithelial ovarian carcinoma.

A second-look operation was performed on 151 patients with stage III and IV epithelial ovarian carcinoma who had responded to primary surgery and chemotherapy. 19% of the 79 patients who appeared clinically to be free of disease had microscopic recurrences and 23% had macroscopic residual disease at a second-look operation. The 5-year survival rate for patients with no histological and for those with microscopic secondaries at second-look operation were 55% and 35% respectively (P = 0.45). Only patients with well or moderately well differentiated tumors and a small residual tumor mass at first operation had a good prognosis after a second-look operation even without further chemotherapy. Median survival after secondary debulking was 15 to 17 months and was independent in the radicality of the second-look procedure. Outside of clinical trials second-look laparotomy should therefore only be performed as a diagnostic procedure in patients with well or moderately well differentiated tumors who are left with a small residual tumor mass at the time of the first operation. Because this is a group of patients in whom chemotherapy can be discontinued after a negative second-look operation.

Carcinoma↗
PubMed1989

Prognostic value of the rupture of the capsule in stage I epithelial ovarian carcinoma.

The prognostic influence of the integrity or the rupture of the capsule was examined in 60 patients with stage I epithelial ovarian carcinoma. After an average follow-up of 75 months (range 30-120 months) the probability of 5-year survival was 76% in both groups. Therefore, we conclude that rupture of the tumor during surgery has no influence on survival rates. Consequently, these patients should not be considered as belonging to the subgroup stage IC ovarian carcinoma, as suggested by the FIGO committee.

Carcinoma↗
PubMed1989

[Current treatment concepts in ovarian cancer].

Surgery plays an important role in the therapeutic procedure in ovarian cancer. An exact staging laparotomy in the early stages and debulking in advanced stages are necessary. In stage I/a respectively I7b (G1), chemotherapy can be avoided. Otherwise cisplatin or carboplatin-containing regimes give the best results. In low peritoneal tumor burden, or in microscopic residual disease intraperitoneal chemotherapy may be an alternative treatment. No clear therapeutic strategy can be given after second-look surgery. In such cases prospective randomized studies are necessary.

Combined Modality Therapy↗
PubMed1988

Escalating dose regimen of intraperitoneal mitoxantrone: phase I study--clinical and pharmacokinetic evaluation.

Mitoxantrone, a recent anthracenedione derivative, is a potentially useful drug for direct intraperitoneal (i.p.) application because of its high tissue binding and therapeutic index. We have carried out studies to establish maximum tolerated doses as well as pharmacokinetic studies with i.p. mitoxantrone in 21 patients (5 male, 16 female) with gastrointestinal (9), ovarian (6), unknown (2) and other (4) primary cancers and peritoneal carcinomatosis. Increasing doses (10-40 mg/m2) were given i.p. every 4 weeks. Five partial remissions (2-8+ months) and 7 stable disease courses (2-6+ months) were achieved. A reduction or disappearance of ascites was seen in an additional 3 patients. Severe toxicity (leucopenia) was observed in 4 patients only after 35 and 40 mg/m2 i.p. Pharmacokinetic analysis using high performance liquid chromatography yielded the following data: The mean ratio of area under curve peritoneal fluid to plasma was 1109. The peritoneal clearance rate was 680 ml/min and the mean disappearance half life was 13.1 h. Mean urinary excretion within 24 h was 0.42% of the i.p. dose. These data indicate that mitoxantrone is sequestered in the intraperitoneal tissue compartment and only slowly released. Based on the outcome of this phase I study we recommend phase II studies at a dose of 30 mg/m2 i.p., repeated every 3-4 weeks.

Adult↗
PubMed1988

[The medroxyprogesterone acetate serum level following various medroxyprogesterone acetate dose schedules in gynecologic oncology].

Medroxyprogesterone acetate (MPA) is used as an adjuvant hormonal medication in patients with different kinds of carcinomas. Since adequate serum levels are thought to be essential we determined the individual, postoperative MPA levels in 36 patients with endometrial carcinoma over a period of 12 weeks. The patients received either an oral dose of 3 X 100 mg MPA or a weekly changing scheme with 2 X 10 mg Tamoxifen and 3 X 100 mg MPA. An additional small group of 4 patients with ovarian carcinoma was enrolled receiving an oral dose of 1000 mg MPA daily. The peripheral serum levels of MPA exhibit enormous inter- and intraindividuell variations and only the high dosage schemes yield levels above 90 ng/ml which are claimed necessary by some authors. The cortisol concentration measured at the same time were within the normal range and did not correlate with the MPA values.

Antineoplastic Agents↗
PubMed1987

[Therapeutic and prognostic results of a prospective multicenter ovarian cancer study of FIGO stages I and II].

Between April 1980 and December 1985 a prospective controlled and randomized multicenter study of 124 assessable patients with stage I and II epithelial ovarian carcinomas was carried out. The aims of this study were first to verify the value of adjuvant irradiation therapy or combined chemo-irradiation therapy, and second to evaluate the importance of different prognostic factors such as age, histology, tumor grading, and tumor stage. Patients with well-differentiated stage IA tumors did not receive any therapy; patients with undifferentiated stage IA tumors were randomized to "no therapy" or irradiation therapy; patients with stage IB, IIA, and IIB tumors were treated by either irradiation or a combined chemo-irradiation therapy consisting of Adriamycin/Cyclophosphamide. In patients with stage IC and IIC ovarian carcinomas a combined irradiation-polychemotherapy was instituted, consisting either of Adriamycin/Cyclophosphamide or of Adriamycin/Cisplatin. Because of the low number of patients and the relatively good prognosis no definite evaluation of the individual therapeutic modalities could be done. An analysis of all patients showed that differentiation between stage I and stage II ovarian carcinomas is the single most important prognostic factor. After a mean observation time of 42 months (8-71 months) for stage I tumors a 91% probability of three-year survival was attained, in comparison with 57% for stage II tumors. It has not been definitely established that there is a need for adjuvant therapy for stage I tumors and this should be confirmed by further studies. Because of the unfavorable prognosis for patients with stage II ovarian cancer, these patients should be given the same polychemotherapy, including Cisplatin, as patients with advanced ovarian carcinomas.

Antigens, Neoplasm↗
PubMed1987

Phase-I study of intraperitoneal mitoxantrone--clinical and pharmacokinetic evaluation.

Mitoxantrone, a recent anthracenedione derivative is a potentially useful drug for direct intraperitoneal (i.p.) application because of its high tissue-binding and therapeutic index. We have carried out studies to establish maximum tolerated doses as well as pharmacokinetic studies with i.p. mitoxantrone in 21 patients (5 male, 16 female) with gastrointestinal (9), ovarian (6), unknown (2) and other (4) primary cancers and peritoneal carcinomatosis. Increasing doses (10-40 mg/m2) were given i.p. every 4 weeks. Five partial remissions (2-8+ months) and 7 stable disease courses (2-6+ months) were achieved. A reduction or disappearance of ascites was seen in an additional 3 patients. Severe toxicity (leukopenia) was observed in 4 patients only after 35 mg/m2 and 40 mg/m2 i.p. Pharmacokinetic analysis using high-performance liquid chromatography yielded the following data: The mean ratio of area under curve peritoneal fluid to serum was 1,108. The peritoneal clearance ranged from 2 ml/min to 9,617 ml/min and the disappearance half-life from 0.6-28.9 h. Mean urinary excretion within 24 h was 0.42% of the i.p. dose. These data indicate that mitoxantrone is sequestered in the intraperitoneal tissue compartment and only slowly released. Based on the outcome of this phase-I study we recommend phase-II studies at a dose of 30 mg/m2 i.p., repeated every 3-4 weeks.

Drug Evaluation↗
PubMed1987

[Effect of a parenteral ozone-oxygen mixture on the concentration of immunoglobulins (IgA, IgG, IgM), of vitamin A and lysozyme activity in patients with cervical cancer].

In the literature you can find several therapeutic possibilities in the treatment of carcinoma by additive ozone therapy. We investigated the consequences of ozone therapy for the immunological status, lysozyme and vitamin A. 21 women with progressive cervical cancer (Stage III, IV) got besides the conventional irradiation therapy also an additive ozone therapy. After irradiation and ozone therapy a small decrease in IgG, IgA and IgM can be seen. A statistical significance could not be evaluated. There was no difference to the control group in lysozyme and vitamin A.

Carcinoma, Squamous Cell↗
PubMed1986

[Ophthalmologic after care of premature infants].

Preterm infants, owing to their relative immaturity of organs and tissues show an increased vulnerability to exogenous factors such as oxygen, which may be required as a life-saving measure. In certain cases this may lead to retinopathy of prematurity and even blindness in the most severe cases. Regular ophthalmological follow up of at-risk infants is, therefore, essential to avoid irreparable retinal damage. From 1.8. 1983 till 31.7. 1985 159 at-risk infants were investigated ophthalmologically by direct and indirect ophthalmoscopy. 14 cases (8.8%) of stage I/II and one case (0.6%) of terminal stage retinopathy of prematurity were observed. In 34 children (21.4%) other changes of lesser (dacryostenosis) or greater pathological severity (hydrophthalmus, disc abnormalities, manifest squint) were seen. Initial results in preterm infants with an improved ophthalmoscopic device für examining the temporal periphery of the fundus, the site of predilection for early retinopathic changes, are reported.

Aftercare↗