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Biomedical subjects

H Schraffordt Koops

Publications and source records attributed to H Schraffordt Koops.

At least 199 records · Page 11Linked to original sources
PubMed1982

[Regional perfusion treatment in primary malignant melanomas of the extremities. (Microstage IV/V according to Clark and tumor thickness over 1.5 mm)].

During the period 1965-1976, 158 patients with stage I malignant melanoma of the extremities were treated by regional isolated perfusion with L-phenylalanine mustard (Melphalan) and local excision. In order to study local recurrence and survival, only patients with a primary melanoma Clark level IV or V and a tumor thickness of more than 1.5 mm were accepted in this study. The determinate survival in patients followed for 5-16 years is 74%; 20% developed positive regional lymph nodes. The local skin recurrence rate was 9% (14 patients); nine of these 14 patients simultaneously had distant metastases; the other five patients are alive with NED after retreatment. So far, this series of patients has shown no statistically significant difference in local recurrence after normothermic and hyperthermic perfusion: 2/19 (11%) and 12/132 (9%), respectively. However, mean tumor thickness in the patients treated by hyperthermic perfusion proved to exceed that in the normothermically perfused patients.

Antineoplastic Agents↗
PubMed1981

Local recurrence and survival in patients with (Clark Level IV/V and over 1.5-mm thickness) stage I malignant melanoma of the extremities after regional perfusion.

During the period 1965-1974, 110 patients with stage I malignant melanoma of the extremities were treated by regional isolated perfusion with L-phenylalanine mustard and local excision. In order to study local recurrence and survival, only patients with a primary melanoma Clark Level IV or V and a tumor thickness of more than 1.5 mm were accepted in this study. The determinate survival in patients followed for 5-14 years in 78%; 17% developed positive regional lymph nodes. The local skin recurrence rate was 9% (9 patients); four of these 9 patients simultaneously had distant metastases; the other five patients are alive with NED after retreatment. This series of patients, too, shows that tumor thickness determines the prognosis, both as to local recurrence and as to survival. The mean tumor thickness in the hyperthermically perfused patients was found to clearly exceed that in the normothermically perfused, the mean values being 4.85 mm and 3.87 mm, respectively. Yet local recurrence and regional lymph node metastases proved to be less frequent after hyperthermic than after normothermic perfusion, although the difference was not statistically significant.

Chemotherapy, Cancer, Regional Perfusion↗
PubMed1981

Tumors of the testis in two brothers: a case report.

This paper describes two nontwin brothers with a nonseminoma tumor of a testicle: an embryonal carcinoma in one and an embryonal carcinoma with seminomatous components in the other. Testicular tumors of the same type have the same frequency in twin brothers as in nontwin brothers. For the present, there is no insight into the genetic influence in the pathogenesis of testicular tumors.

Adult↗
PubMed1981

The treatment of infantile embryonal carcinoma (Yolk-Sac Tumour) of the testis in children.

The case histories of five patients with an infantile embryonal carcinoma are presented. Personal observations and data from the literature indicate that treatment of this tumour is dependent on the patient's age. Non-operative staging is possible under age 1 (alpha 1-foetoprotein and CT-scan). Staging should include a laparotomy in patients aged between 1 and 2 years. Under age 2, retroperitoneal lymph node dissection is indicated only if metastases are demonstrable. From age 2 on, retroperitoneal lymph node dissection should be performed if possible: unilaterally in the absence, and bilaterally in the presence of retroperitoneal metastases. Chemotherapy is required only in cases with metastases. Radiotherapy is not indicated in the treatment of infantile embryonal carcinoma.

Bleomycin↗
PubMed1981

Tumor markers in patients with non-seminomatous germ cell tumors of the testis.

In 82 patients with non-seminomatous germ cell tumors, the levels of alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG) and lactate dehydrogenase (LDH) were determined to find if there was a relation to clinical stage. Only two out of 34 patients could be restaged as a result of the presence of elevated marker levels. Markers were present in 12% of patients with stage IIA, 67% with stage IIB and 85% with stage III. In contrast to HCG, the initial levels of LDH and AFP were related to tumor stage. A return of marker levels to normal during chemotherapy always meant tumor regression and indicated complete remission in 42% of patients. Initial marker levels did not correlate with the eventual destructionn of all tumor by chemotherapy. A rise in marker levels always correlated with tumor progression. In conclusion, tumor markers have only a limited value in clinical staging. Disappearance of markers during chemotherapy does not always indicate destructio of all viable tumor, probably because non-producing cell lines such as mature teratoma may persist after chemotherapy.

Adolescent↗
PubMed1981

The value of AFP and HCG half lives in predicting the efficacy of combination chemotherapy in patients with non-seminomatous germ cell tumors of the testis.

The decline of serum levels of AFP or HCG in 26 patients with disseminated non-seminomatous germ cell tumors during chemotherapy showed two different patterns: a linear decline or an increasing apparent half life (AHL). The initial AFP half life in 13 patients with a linear decline was 7.2 +/- 1.8 days, and did not differ from the initial half life in 5 patients with a curvi-linear pattern. HCG half life was 3.0 +/- 0.5 days in 10 patients with a linear AHL, and was not different from the initial half life in 6 patients with delayed marker disappearance. Based on the half life pattern of AFP or HCG the result of chemotherapy was predicted. When AFP or HCG showed a linear decline, all viable tumor appeared to be eliminated in 38 and 40% respectively of the patients. An increasing AHL indicated the presence of active tumor, mostly mature teratoma, in 60% of the patients with AFP and in 83% of the patients with HCG. Thus, the pattern of AFP or HCG half life does not predict the eventual outcome of chemotherapy with certainty.

Adolescent↗
PubMed1980

The relation between testicular tumours, undescended testes, and inguinal hernias.

A group of 230 patients with a malignant testicular tumour was found to include 12 patients with a history of an undescended testis (5.2%). Eight patients had a history of inguinal hernia (3.4%). The risk of malignant degeneration in an undescended testis proved to be 17 times greater than in the normal population. We found no increased risk for patients with a history of inguinal hernia. Nine patients with a history of orchiopexy developed a malignant testicular tumour; inguinal lymph node metastases were found in three of them. We advise the removal of all undescended testicles after puberty. In cases of malignant degeneration of a testis, which have been fixed in the scrotum, or in cases with a history of an operation in the inguinal region, the inguinal lymph nodes have to be treated. For seminoma, irradiation of these nodes is necessary; for non-seminoma tumours, hemiscrotectomy and inguinal lymph node dissection have to be performed.

Adolescent↗
PubMed1980

Embryonal rhabdomyosarcoma of spermatic cord.

This article discusses 2 patients with embryonal rhabdomyosarcoma of the spermatic cord and presents a survey of the literature and therapeutic methods. In recent years the prognosis of this malignant tumor has improved significantly by virtue of a combination of radical inguinal orchiectomy and retroperitoneal lymph node dissection with supplementary chemotherapy and/or radiotherapy.

Adult↗
PubMed1979

Combination chemotherapy with cis-diammine-dichloro-platinum, vinblastine, and bleomycin in advanced testicular non-seminoma.

40 patients with disseminated testicular non-seminoma were treated with cis-diammine-dichloro-platinum, vinblastine, and bleomycin. Complete remission was achieved in 24 (60%) patients and partial remission in 11 (28%). 22 of the 24 complete responders, who have been followed-up for a median of 11 months, have been tumour-free for 5--30 months. There were 3 drug-related deaths. This regimen is the most effective remission-induction treatment available for disseminated testicular non-seminoma. Patients should be treated in centres experienced in the specialised management of this potentia-ly curable disease.

Adolescent↗
PubMed1979

Two extensive giant-cell tumours of the proximal humerus treated by resection-reconstruction or excochleation-cryosurgery.

Giant-cell tumours of bone occur infrequently. Recurrence is often observed following excochleation. Due to the fact that most of these tumours are located in the epiphysis of long bones, treatment of extensive tumours with preservation of joint function usually is troublesome. Two patients are presented: one underwent resection and implantation of an endoprosthesis, the other one excochleation in combination with cryosurgery.

Adult↗
PubMed1978

Cryosurgical treatment of aneurysmal bone cysts.

An aneurysmal bone cyst is a benign, locally aggressive bone process which frequently recurs after excochleation. Exocochleation can be extended without loss of bone tissue by making use of cryosurgery. This combined technique was used in the treatment of 5 patients, without complications. None of the patients described had a demonstrable recurrence 12-60 (average 35) months after this combined therapy.

Adolescent↗