[Combined treatment of corpus cancer. Results and side effects in 496 patients].
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Adenocarcinoma↗
Biomedical subjects
L M Ahlemann
Publications and source records attributed to L M Ahlemann.
[Unusual abscess formation in the posterior mediastinum (author's transl)].
Pathological processes in the interpleural space appear on x-ray film as space-occupying growths. The assessment of such processes will always require x-ray films of the thoracic organs in two planes, rotating fluoroscopy and spot films as well as tomography. Additional information is obtained via oesophagus contrast radiography, angiography and mediastinoscopy. Computer tomography, being a non-invasive method, has proved very effective in such cases. Formation of an abscess in the mediastinum is rare, since the usually preceding mediastinitis is fatal even before an abscess is formed. In patients from countries where tuberculosis is still frequent, the possibility of formation of a cold abscess via liquafaction of specifically infected lymph nodes must be included in the differential diagnosis of mediastinal enlargement.
Abscess↗
[Prognosis of recurrences in case of operated and post-irradiated carcinoma mastitoides (author's transl)].
Between 1970 and 1973, 411 patients suffering of carcinoma mastitoides of all stages were post-irradiated under high-voltage conditions in the Institute of Radiology in Tübingen. These cases were evaluated in order to study the importance of the appearance of a local or regional recurrence. 65 of the patients (= 15,8%) presented recurrences; in 28 of these cases a remote formation of metastases could be diagnosed already before the appearance of the recurrence or at the same time. In 37 cases (=9%) the recurrence was the first and, in the beginning, the only symptom showing a progression of the primary disease. Only a short time later, 30 of these 37 patients were affected with new tumor manifestations. In most of these cases, a close correlation in time can be demonstrated between the appearance of the recurrence and other manifestations of the tumor.
Breast Neoplasms↗
Carcinoembryonic antigen (CEA) measurements as an aid to management of patients with lung cancer treated by radiotherapy.
Serial CEA measurements performed in 102 lung cancer patients during and after radiotherapy and chemotherapy correlated well with the course of disease. CEA levels above 10 ng CEA/ml prior to radiotherapy signaled metastatic spread even when this was not evident from clinical staging of the patient (TNM). This finding contributed to the early adoption of radiotherapy in favor of palliative treatment. Alterations of the CEA concentration during therapy could be used for monitoring the efficiency of treatment. Increasing CEA levels always signaled disease progression, decreasing CEA levels were found to be associated with improvement. In the posttreatment follow-up, increasing CEA levels were always reliable predictors of recurrent disease. Slope analysis of the posttreatment CEA time courses discriminated bone and/or liver metastases with a slope greater than 0.5 ng/ml/10 days from local recurrences, lymph node, lung and brain metastases with slope values less than 0.5 ng/ml/10 days.
Carcinoembryonic Antigen↗
Serial carcinoembryonic antigen (CEA) determinations in the management of patients with breast cancer.
Serial CEA determination have been performed in 335 patients with operable breast cancer who received radiotherapy and then were the subjects of a long-term follow-up study. Tumor extension was staged by the surgeon according to the TNM classification. Elevated pretreatment CEA levels (greater than 10 ng/ml) indicated metastatic spread even when this was not evident from the original TNM classification. Elevated CEA levels of greater than 4 ng/ml also led to a reevaluation of patients and in 20% metastatic spread was found. Therapy was adapted when patients had demonstrable distant spread. Response to treatment could be correlated with decreasing CEA levels while increasing CEA levels were generally found when disease progression was observed. During long-term CEA follow-up, 80% of recurrent cancers were signaled by increasing CEA levels. A mean lead time of 4.8 months was calculated for the initial CEA increase before clinical confirmation. Slope analysis of the posttreatment CEA time course represented a numerical parameter which was characteristic for osseous and/or liver metastases when values of greater than 0.5 ng/ml/10 days were recorded. Soft tissue, lymph node, lung and brain metastases showed generally a slope value of less than 0.5 ng/ml/10 days.
Adult↗
Serial CEA determinations as an aid in postoperative therapy management of patients with early breast cancer.
Serial CEA measurements as an aid in routine clinical diagnostic methods was investigated in 69 women with early breast cancer. In 14/69 cases detection of metastatic spread on the basis of elevated pretreatment CEA levels together with clinical aspects led to early adaption of treatment. 27 patients had no metastatic spread (group I) and 28 patients had lymph node metastases (group II). During the follow-up of 55 patients of group I and II, disease progression was signaled by rising CEA values in 10/11 cases with a lead time of up to 8 months before a positive clinical diagnosis was possible. For another 6 patients disease progression has to be expected because of consecutively increasing CEA levels. Patients of group II exhibited a higher frequency of relapses compared to group I patients. Decreasing CEA levels could be correlated in our study with patients who were considered to have had a successful treatment by local radiotherapy and who showed no recurrence during surveillance period along with normal CEA values. About 30% of the patients, however, showed essentially unchanged CEA levels mostly in the normal range.
Adult↗