Biomedical subjects

J Flamm

Publications and source records attributed to J Flamm.

At least 55 records · Page 3Linked to original sources

PubMed1986

[Dedifferentiated superficial bladder cancer with invasion of the lamina propria (pT1 GIII)].

On the basis of a retrospective investigation in 45 patients with a carcinoma of the epithelium of the urinary tract pT1 GIII and primary conservative therapy the prognostically relevant factors are controlled. The primary multifocality, the positive dysplastic findings of the biopsies of the mucous membrane and the lacking tumour-associated cell infiltration appeared as high risk for recidivation and tumour progression. The size of the tumour was prognostically not relevant. The rate of recidivations was 53.3%, the tumour progression 37.5%. The 3-year survival rate was 65%, the 5-year rate survival 47%. A conservative therapy of the pT1 GIII tumour is recommended, but at the same time a possibly close-meshed control particularly of the high-risk group is demanded.

Adult↗

PubMed1986

[Adjuvant topical chemotherapy with cisplatin in superficial bladder cancer].

During a period of 6 weeks we applied a weekly dosage of 50 mg of cis-platinum as an intravesical instillation treatment to 30 patients with superficial carcinomas of the urinary bladder. Prior to this treatment these patients had undergone a transurethral differentiated resection of their tumours by multiple biopsies (mapping). Persistent tumours were found in 3 patients (10%). After an observation time of 22 months the relapse rate in pTa tumours was 5.5 and in pT1 tumours 7.6.

Administration, Topical↗

PubMed1985

[So-called benign papilloma of the bladder. A retrospective study].

A retrospective study of 34 patients with histologically verified, so called "benign" papilloma of the mucuous membrane of the urinary bladder (pTa GO) served as a basis for investigation of the course of the condition, the tendency to recurrence and the development of carcinoma. A histologically identical recurrent tumour was found in 53% of the patients, while 85% developed a urothelial carcinoma in a period of between 1 and over 10 years. From the time of the diagnosis of papilloma, the 5-year survival rate was 87% and the 10-year survival rate was 76%. From the time of the carcinoma diagnosis the 5-year survival rate was 40%, none of the patients survived 10 years.

Adult↗

PubMed1985

Bladder carcinoma following cyclophosphamide therapy. A case report.

Cyclophosphamide was introduced in 1958 in an effort to minimize the side effects of nitrogen mustard. Cyclophosphamide (Cytoxan, Endoxan) is not an alkylating agent which has been used for the treatment of a variety of non-malignant as well as malignant diseases. It has also recently been the focus of considerable interest as an immunosuppressive agent, perhaps the most potent immunosuppressive drug that has been synthesized. Reports of urologic complications from this drug are haemorrhagic cystitis, vesical fibrosis and urothelial carcinoma.

Adult↗

PubMed1985

Prophylactic use of topical adriamycin after transurethral resection of transitional cell bladder tumours.

Thirty-five patients with carcinoma of the bladder were subjected to weekly intravesical instillation treatment with 30 mg adriamycin/50 ml solution for a period of 6 weeks following transurethral resection of the tumour. The oncolytic and thus recurrence-preventive value of treatment was determined by endoscopic controls with exploratory excisions and exfoliative cytology. All in all, a recurrence-free rate was found in 77% over a minimum observation period of one year. These results are definitely better than those of comparable instillation treatments with surface-active or immunologically active substances.

Administration, Topical↗

PubMed1985

[Significance of local tumor associated infiltration of mononuclear leukocytes for persistent tumor formations following transurethral resection (TUR) of bladder cancers].

In 140 patients with primarily curatively resected tumour of the urinary bladder the inclination to persistence was investigated in relation to the local peritumoural infiltration of leucocytes. 19% of the tumours with cellular infiltration and 33% of the tumours without cellular infiltration showed persistent tumour formations. Altogether 30 (21%) of the 140 tumours were persisting. The following parameters were found in persistent tumour formations: Multifocal tumours have a higher persistence rate than isolated primary tumours. With increasing degree of malignancy (G) the rate of persistence is elevating. It seems that in differentiated transurethral resection (separate resection of the exophyte, the tumour basis, resection of the marginal wall, if necessary, with second look operation) the local depth spreading of the tumour has no influence on the rate of persistence. Tumours without peritumoural infiltration with mononuclear leucocytes show a higher persistence rate than tumours with cellular infiltration, in which case this difference becomes even more significant with advanced tumour formation (T) and degree of malignancy (G).

Aged↗

PubMed1985

[Prevention of recurrence in urinary bladder tumors by intravesical instillation treatment with adriamycin].

109 patients with urinary bladder cancer received post TUR treatment with weekly intravesical instillations of Adriamycin for a period of 6 weeks. 32 patients received a dosage of 10 mg/50 ml physiological NaCl, 35 patients a dosage of 30 mg/50 ml physiological NaCl. We determined the oncolytical value and the value of prophylactically reduced recurrence through urine cytology and endoscopic controls with biopsies. After an observation period of 1 year the result was the same in all groups; 13% had a persistent tumour, 71% remained recurrence free. By raising the dosage of Adriamycin we achieved a reduction in the persister rate from 31% with 10 mg/50 ml NaCl to 6% with 30 mg/50 ml NaCl and to 5% with 50 mg/50 ml NaCl. There was no significant correlation between dosage and recurrence rate. The recurrence rate after a dosage of 10 mg/50 ml was 31%, after 30 mg/50 ml 73% and after 50 mg/50 ml 33%. The increasing recurrence rate correlates with the intensity of local tumour infiltration and with the grading of the primary tumours.

Administration, Topical↗

PubMed1984

[Peritumoral infiltration of mononuclear leukocytes and clinical course in bladder cancer].

Peritumoral infiltration by mononuclear leucocytes was investigated in 27 recurrent-free cases of bladder cancer and also in 22 cases which had taken an unfavourable course. The investigation was undertaken in all cases after transurethral resection of the tumour and intravesical instillation of adriamycin or BCG. 67% of the recurrence free cases showed peritumoral infiltration by inflammatory cells, whilst the remaining 33% failed to show any such reaction. Of the patients in whom the disease was progressive only 5% showed peritumoral infiltration with mononuclear leucocytes, whereas 95% demonstrated no such cell infiltration. Of 19 patients with tumour-associated inflammatory cell infiltration 95% remained recurrent free, whereas of 30 patients lacking this response only 30% remained recurrence free.

Aged↗

PubMed1984

[Surgical therapy of metastasizing kidney cancer. A retrospective study].

This is a report on the therapeutical results in 38 patients with advanced renal cell carcinoma (Robson stage III and IV). We compared: palliative tumour nephrectomy (n = 10), transfemoral embolisation of the tumour or operative occlusion of the renal vessels (n = 6) and tumours which were primarily or secondarily inoperative (n = 22). In Robson stage II 3 out of 8 patients died after palliative nephrectomy and 6 out of 8 patients died after laparotomy. In Robson stage IV 1 out of 2 patients died after palliative nephrectomy, 5 out of 6 patients died after embolisation and 12 out of 14 patients died before or after laparotomy. The 3 year survival rate for patients with a tumour Robson stage III was 3 out of 8 after palliative nephrectomy whereas none of the patients survived after laparotomy, or without operative treatment. In Robson stage IV none of the patients survived after nephrectomy, only 1 survived after embolisation and 1 patient survived without operative treatment for 3 years. The result of this retrospective study shows that tumour nephrectomy is advisable in Robson stage III with only focalised metastasis of the lymph nodes (N1-2), whereas there are no favourable results in Robson stage IV with an advanced metastasis of the lymph nodes.

Adenocarcinoma↗

PubMed1984

The value of the DNCB test in bladder cancer. Pretreatment evaluation of immune function and 5-year follow-up of patients with urinary bladder cancer.

In 68 patients with histologically verified tumors of the urinary bladder, cell-mediated and humoral immune parameters were investigated before therapy and the results were re-evaluated after a 5-year observation period in order to correlate them with relapse rate and survival time. Skin test reactivity, as measured with recall antigens (tuberculin, streptokinase-streptodornase, mumps, toxoplasmin and candidin), and serum levels of immunoglobulins do not differentiate between levels of invasion and grade of malignancy. However, it was found that patients with tumors of high grades of invasiveness and malignancy were anergic to the primary skin test antigen dinitrochlorobenzene (DNCB). Furthermore, a correlation between anergic reactivity to the DNCB test and absence of local inflammatory reactions at the tumor site was detected, showing that patients with a negative DNCB challenge test were those in whom no immunocytes could be detected in the intra- and peritumoral area. Survival time and incidence of relapse were also correlated with initial skin test reactivity to DNCB, i.e. all patients with tumor stage pT3 and skin test anergy developed recurrences and died within the 5-year observation period. The correlation between morphological inflammatory criteria and immunological parameters detected in patients with advanced tumor stages should therefore be taken into consideration when taking therapeutic decisions at the time of diagnosis.

Aged↗

PubMed1984

[Can the persistence rate of transurethrally resected bladder tumors be lowered by postoperative instillation of silver nitrate?].

In 19 out of 88 patients (22%) who had undergone transurethral resection of urothelial carcinoma of the urinary bladder persistent tumours occurred (= tumour detected locally within 3 months). Among 52 patients who had had TUR of urothelial carcinoma and postoperative silver nitrate instillation persistent tumours were found in 11 cases (21%). The persistence rate correlates to the depth of infiltration and the dedifferentiation of the primary tumour. Even in homogenous follow-up groups immediate postoperative instillation of silver nitrate shows no effect on the persistence rate.

Carcinoma, Transitional Cell↗

PubMed1984

[Prevention of the recurrence of superficial bladder cancer].

A report is given on recidive prophylaxis in connection with 204 superficial urothelial tumours (pTa and pT1 ) of the urinary bladder. 30 patients received postoperative Betatron or Telekobalt irradiation. The relapse rate was 53%. 24 patients were given a local active unspecific immunotherapy with BCG. The relapse rate was 50%. 48 patients received a local and systematic therapy with vitamin A. The relapse rate was 63%. 102 patients underwent local instillation therapy with Adriamycin. The relapse rate was 27%. The results are classified according to the clinical manifestation (isolated or multifocal tumour, primary or recidive tumour), the infiltration (pTa or pT1 ) and the degree of dedifferentiation of the tumours and discussed in the light of the literature.

Aged↗

PubMed1983

[Therapy of metastasizing kidney cancer with hormones (androgens). A retrospective study].

A report is given on the results of a hormone therapy of metastatic renal carcinomas using androgens. Out of 38 patients with Robson stage III or IV renal carcinomas, palliative tumour nephrectomy or embolization of the renal artery was operatively performed. 23 patients underwent no operation. 20 patients received 250 mg testosterone per week for 4 weeks and then per month. 18 patients had no therapy. 14 out of the group of 20 with androgen therapy died within a year (70%), 3 patients survived for more than 3 years. 13 out of the group of 18 without androgen therapy (72%) died within a year, 2 (11%) survived for more than 3 years. In no case was a remission observed.

Adenocarcinoma↗

PubMed1983

[Prevention of recurrence using telecobalt and betatron irradiation after transurethral resection of bladder tumors].

Following transurethral resection of the tumours, 86 patients with urothelial carcinoma of the urinary bladder were subjected to field irradiation treatment (6000 R). Percutaneous high-voltage therapy with cobalt 60 was given to 51 patients and 35 patients were exposed to ultra-hard X-rays from al 17 MeV betatron. Taking into account tumour staging and grading, there was no difference between the two groups as far as prevention of tumour recurrence is concerned. Tumour recurrences occurred in 63-65 percent of the cases. Following betatron irradiation, there was an average five-year survival rate of 54 percent, following telecobalt irradiation, the figure was 41 percent.

Aged↗

PubMed1982

[Surgical treatment of malignant kidney tumours (author's transl)].

In 51 patients with malignant kidney tumours, who were checked up postoperatively over a time of at least five years, the tumour nephrectomy was carried out lumbodorsally in 19 cases (37.2%) and transperitoneally in 32 cases (62.7%). There was a total survival rate of 49% after five years. When using the lumbodorsal technique of tumour nephrectomy the five year survival rate came to the total of 52.6%, in T2-tumours to 62% and in T3-tumours to 0%. By taking the transperitoneal way the five year survival rate amounted to the total of 53%, in T2-tumours to 70% and in T-3 tumours to 36%. Large tumor size and signs of tumour invasion can definitely be considered as prognostically unfavourable factors. In such cases the transperitoneal technique of tumour nephrectomy yields better chances of survival. When taking into consideration the heavy chances of understaging a tumour diagnostically and the possibility of local tumour invasion even in small tumours, it is of great importance the transperitoneal technique as the method with the best possible results.

Adenocarcinoma↗

PubMed1982

[Chemo-immunotherapy in disseminated malignant testicular tumors].

Since 1978 we have treated 26 patients with testicular cancer in stage IV with the following chemotherapy regimen: Vinblastine 6 mg/m2 (day 1 and 2) and bleomycin 30 mg given over 24 hour period (day 1 to day 5). After two cycles this therapy was changed and patients received the combination adriamycin 60 mg/m2 (day 1) and cis-DDP 20 mg/m2 (day 1 to 5) for further two cycles. We achieved 69% (18 of 26 patients) complete remissions. Patients without response or no change received as second treatment modality vincristine 0,8 mg/m2 (day 1) and ifosfamide 1500 mg/m2 (day 1 to 5). Before each chemotherapy in an interval of two days 1 Unit (= 1 KE) of OK-432 (Streptococcus pyogenes) preparation, an immunomodulating agent, was given intravenously. In the therapyfree interval of chemotherapy 2 KE of OK-432 were applied. The maintenance therapy for 1 year consisted of vinblastine and trofosfamide and also OK 432. For the achievement of complete remissions 4 courses of chemotherapy seemed to be sufficient. The inclusion of OK 432 immunotherapy in an already established chemotherapy regimen seems to be qualified due to the reduction of chemotherapy induced side effects (myelosuppression, immunodeficiency) and the immunorestoration achieved before chemotherapy.

Adult↗

PubMed1982

[Correlation of the immune profile with local immunocyte infiltration in urinary bladder tumours (author's transl)].

In 40 patients with urinary bladder tumours we compared the results of the immune profile, obtained by means of cutaneous tests with dinitrochlorobenzene (DNCB), and the infiltration of immunocompetent cells in the histological pattern after transurethral tumour resection. It was noted that the more the tumour had infiltrated, the less was it possible to immunize with DNCB or to achieve an immunocyte infiltration in the tumour. According to the classification of the WHO there was a positive reaction in 56-67% and a correlating immunocyte infiltration in 50-73%.

Aged↗

PubMed1982

[Adjuvant local instillation with vitamin A in the therapy of bladder tumours following transurethral resection].

Following transurethral resection of the tumour, 58 patients with histologically verified transitional cell carcinoma were subjected to local instillation treatment and oral vitamin A therapy. The instillation were carried out once a week over a 6-week period; cystoscopy with biopsy were carried out at 3-month intervals over an average period of 2.7 years. The vitamin A treatment appears to have no positive effect on persistent growth and on tendency to recurrence.

Aged↗