Biomedical subjects

J Pont

Publications and source records attributed to J Pont.

At least 55 records · Page 3Linked to original sources

PubMed1990

Risk-adapted treatment choice in stage I nonseminomatous testicular germ cell cancer by regarding vascular invasion in the primary tumor: a prospective trial.

Based on the results of a retrospective study, which found blood vessel invasion to be the most important prognostic factor in clinical stage I nonseminomatous testicular germ cell cancer (NSTGCC I), a prospective study was started in 1985 which assigned NSTGCC I patients without evidence of vascular invasion to surveillance and patients with vascular invasion to two cycles of adjuvant chemotherapy with cisplatin, etoposide, and bleomycin. Twenty-two patients entered the surveillance group and 18 patients received adjuvant chemotherapy. Median follow-up is 30 months (3 to 50 months). Relapses occurred in three patients (7.5%), one in the surveillance group (4.5%), two in the chemotherapy group (11%). Thirty-eight patients (95%) are alive and without evidence of disease. Two patients of the adjuvant-treated group died, one of progressive germ cell cancer and one of lung cancer. We conclude that low- and high-risk NSTGCC I patients can be identified by considering blood vessel invasion. The presence of embryonal carcinoma and vascular invasion seem to be interrelated prognostic factors, because in 94% of vessel invasion the invading element was embryonal carcinoma. The exclusion of patients with vascular invasion from surveillance decreases relapse rates remarkably. Adjuvant chemotherapy diminishes relapse rates in high-risk patients but does not entirely prevent relapse.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1987

[Is lymphadenectomy in stage I of non-seminomatous testicular cancer still justified?].

Testicular cancer is the tumour of the male genital tract which is most easily and successfully treated today. This very circumstance dictates that for ethical reasons we are more bound than ever to prevent unnecessary diagnostic and therapeutic procedures in these young patients. They should receive only the maximum necessary and not the maximum possible therapy. The difference between these two critical concepts determines the extent of treatment morbidity. Retroperitoneal lymphadenectomy (RLA) is only a diagnostic procedure in approximately 85% of cases. This is the reason for critically reviewing the necessity of this investigation in early non-seminomatous cancer of the testes. The prognostic impact of vascular invasion by the primary tumour is demonstrated in a retrospective study of 86 pathohistological specimens of germ cell tumours. We suggest the inclusion of vascular invasion basically as criterion for any prospective "wait and see" protocol in early non-seminomatous germ cell tumours.

Combined Modality Therapy↗

PubMed1987

Testicular cancer: prognostic implications of vascular invasion.

In a retrospective study the primary tumors of 33 patients with seminomas and 53 with nonseminomatous germ cell tumors were re-evaluated for vascular invasion. The significance of vascular invasion was analyzed in respect to the appearance of visceral metastases and the effect of adjuvant chemotherapy. Vascular invasion was demonstrated in 27 per cent of the patients with seminomas and 53 per cent with nonseminomatous germ cell testis tumors, while visceral metastases appeared in 9 and 32 per cent, respectively. Without adjuvant chemotherapy all 13 patients with nonseminomatous germ cell testis tumors and vascular invasion had metastases, compared to only 3 of 13 without vascular invasion (p less than 0.0005). Of 9 patients with seminoma and vascular invasion 3 had tumor progression, compared to 1 of 24 without vascular invasion (p greater than 0.05). With adjuvant chemotherapy only 1 of 15 patients (7 per cent) with nonseminomatous germ cell testis tumors and vascular invasion had metastases, compared to 100 per cent of 13 without this treatment. No significant correlation was noted between pT stage versus vascular invasion and pT stage versus tumor progression. The results demonstrate the importance of vascular invasion in the staging of and choice of treatment for early nonseminomatous germ cell testis tumors.

Adolescent↗

PubMed1986

[HTLV-III serology, epidemiology and clinical aspects of imprisoned i.v. drug-dependent males in Austria].

Sera of 71 intravenous drug abusers imprisoned in Austria were tested for HTLV-III antibodies and the results correlated with the case histories and available clinical data. 12 sera, i.e. 17%, were found to be positive. Seronegative and seropositive drug addicts showed no notable difference regarding the average duration of previous drug abuse or the incidence of sexually-transmitted diseases. Among HTLV-III seropositive drug addicts there was found to be a significantly higher incidence of frequent needle-sharing and history of previous i.v. drug abuse in Amsterdam. 6 of 12 HTLV-III seropositive drug addicts had developed the lymphadenopathy syndrome (LAS); chronic liver disease and positive hepatitis B serology were equally frequent in HTLV-III seronegative persons, HTLV-III seropositive persons without symptoms and LAS patients.

Acquired Immunodeficiency Syndrome↗

PubMed1985

CHOP-firstline treatment in NHL with unfavorable prognosis--evaluation of therapeutic response and factors influencing prognosis.

58 NHL-patients (9 large cell centrocytic, 18 centroblastic, 16 immunoblastic, 15 lymphoblastic lymphomas) were treated immediately after diagnosis with CHOP-chemotherapy regardless of the extent of disease. Because of the advanced age of the majority of patients (median age 61 years, range 22-85 years) a reduced dose in the first two cycles was administered. Statistically significant prognostic variables influencing survival were the following: histologic subtypes according to the Kiel-classification (p less than 0,05), B-symptoms (p less than 0,001), blood sedimentation rate (p less than 0,02) and LDH (p less than 0,0005). With regard to prognosis there was no difference between patients over 60 years of age and younger ones (p less than 0,4). Patients achieving complete remission survived significantly longer (p less than 0,0001). Ann Arbor stages were of limited value, since patients with CS II disease and accumulation of risk factors (B-symptoms, abdominal disease, bulky tumor masses) showed a poorer outcome than patients with CS III who did not have these risk factors. A risk factor score summarizing features influencing prognosis is described and might be a useful tool in stratifying the heterogeneous group of NHL with unfavorable prognosis.

Adult↗

PubMed1984

[Testicular tumor staging: the ranking of CT and ultrasonic diagnosis].

In a retrospective study 79 patients suffering from a tumour of the testis were analysed between March 1977 and March 1983. Of these, 31 patients were examined via CT. The radiologist's task was the staging of these cases. The results show the superiority of CT diagnosis, which led to only one false-negative report. For the evaluation of stage II ultrasonography is useful, too, even though small lymphomas might be overlooked. If CT is not available, sonography, which is less costly, might be a good substitute. With regard to cooperative therapy, staging together with the histology of the primary tumour and determination of tumour markers are of essential importance.

Adolescent↗

PubMed1979

[Diagnostic value of alkaline leucocyte phosphatase in hematology (author's transl)].

The diagnostic value of the Alkaline Leucocyte Phosphatase (ALP) was checked on the basis of the patients of a hematologic department. Reliable data can only be obtained for the differential diagnosis of polycythemia vera and secondary polycythemia, not however for the differential diagnosis of chronic myeloid leukemia (CML) and myelofibrosis. In CML the ALP is an aid for evaluating the course of the disease and its remissions. In Hodgkin's disease it is an objective parameter for actiivty of the disease. The leucocyte concentration method can be used for evaluation of the ALP.

Alkaline Phosphatase↗

PubMed1977