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Biomedical subjects

M Lahousen

Publications and source records attributed to M Lahousen.

At least 91 records · Page 5Linked to original sources
PubMed1990

[The surgical treatment of ovarian cancer].

Between 1980 and 1988, 350 women suffering from ovarian cancer stage I-IV were admitted to the Department of Gynaecology and Obstetrics of the University of Graz. 320 patients underwent surgery, 174 of 175 with stage III disease, 95 patients had a pelvic lymphadenectomy and 76 both pelvic and para-aortic lymphadenectomy. During the last 4 years, 75% of all patients with stage III disease underwent lymphadenectomy; in 30% the abdomen could be completely cleared of the disease. Bowel resection was necessary in 29% of these patients. After surgery and adjuvant chemotherapy, actuarial 5-year survival was 80% in stage I, 65% in stage II. and 45% in stage III. Lymph node status and amount of residual tumour were the most important factors affecting survival. After pelvic lymphadenectomy 23% patients of stage III showed no evidence of disease (NED) after 5 years. If there was no residual tumour at primary surgery, survival with NED increased to 62% and to 71% in patients with negative pelvic nodes. The data indicates, that pelvic lymphadenectomy improved the 5-year survival of patients with stage II-IV ovarian cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

[Tumor marker combination versus second-look operation in ovarian cancer].

Tumour markers are substances that occur at elevated blood levels in patients with certain tumours. When their specificity and sensitivity are known, markers can be used to monitor cancer patients. No single marker is specific and sensitive for a certain tumour, so a tumour-marker combination is used. The efficacy of CA 125, ferritin, TPA and CEA was demonstrated in 162 ovarian cancer patients. With the same combination, we found a statistically significant 91.7% correlation between the clinical course of the disease and the marker profile in 60 further patients. Tumour markers can also help make a prognosis. In 34 patients the marker profile accurately predicated the findings at second-look surgery. Thus, biochemical monitoring may supplant the second-look procedure. 68 patients were followed for a mean of 2.7 years after completion of chemotherapy. In 95.6% the tumour-marker analysis correlated with the clinical and radiologic course. This means that the end of chemotherapy depends on biochemical monitoring, and second-line therapy can be initiated sooner.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1990

[Adjuvant chemotherapy in radical surgery of cervix cancer].

Invasive cervical cancer can be treated by surgery, radiotherapy, and cytostatic chemotherapy. For decades, surgery alone or in combination with radiotherapy has been the treatment of choice. Radiotherapy only was reserved for patients with advanced disease. Antineoplastic agents, especially combinations including cisplatin, achieved good results in patients with advanced disease of after other therapeutic modalities had been exhausted. This led us to use postoperative chemotherapy for high-risk patients with positive pelvic or parametrial nodes or vascular invasion. Radiotherapy had not improved the survival of such patients. A combination of bleomycin, vincristine, mitomycin-C and cisplatin and later a combination of carboplatin and bleomycin was used. The results were compared to those of patients with radical abdominal surgery only (N = 118) or with surgery and postoperative radiotherapy (N = 108). The 32 patients who underwent surgery and chemotherapy had statistically higher incidence of all risk factors. Nonetheless, after 4-year follow-up they had less recurrences and deaths than the other patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Labile disulfide bonds and free thiol groups in human IgG. V. Association of postoperative mean 'sigma S' course and tumor recurrence in ovarian cancer.

Sigma S comprises both free thiol groups and labile S-S-bonds of the total IgG that react with dithionitrobenzoate. Previous investigations have shown that this parameter was significantly decreased in malignant diseases of various organ systems as compared with benign disorders of the respective organs. The present study on patients with ovarian cancer investigated whether a significant correlation exists between the post-operative course of sigma S and the clinical evidence. For this purpose, on the basis of former results, a value of sigma S of 1.25 was determined as a criterion between malignant and benign ovarian diseases. For each investigated case, the post-operative temporal average of sigma S was calculated (sigma S) and a value of 1.25 was used as discriminating threshold. A four-fold table was set up containing the frequencies of tumor recurrences and tumor free cases with sigma S less or greater than 1.25. In a total of 40 patients of ovarian cancer an association between sigma S less than 1.25 and increased frequency of recurrences was confirmed, with a probability of error of 1%. The total predictive value of the sigma S level was about 70% and is herewith comparable to the leading tumor marker CA 125 in ovarian cancer.

Biomarkers, Tumor↗
PubMed1989

Labile disulfide bonds and free thiol groups in human IgG. IV. Use of the "sigma S" value for postoperative monitoring of gynaecological malignant tumors.

"sigma S" comprises both disulfide bonds reactive to dithionitrobenzoate, as well as free SH groups of serum immunoglobulin G. In 38 cases of invasive gynaecological tumors, the value of sigma S was ascertained to be 1.04 +/- 0.25 (mean +/- SD), which, in accordance with former results, differs significantly from the reference value of 1.51 +/- 0.36 (2 p less than 0.001). 14 days after surgery, at the latest, sigma S significantly increased to an average value of 1.33 +/- 0.26 (2p less than 0.001). This increase was apparently influenced by both the localisation, as well as by the completeness of removal of the tumors. Of 15 squamous cell carcinomas of the cervix uteri, 14 were radically removed and showed a highly significant postoperative increase in the sigma S value (2p less than 0.001). All of the 12 adenocarcinomas of the corpus uteri were totally removed and the sigma S increased significantly (2p = 0.05). Of 11 cystocarcinomas of the ovary, only 3 cases were completely operable. The remaining 8 cases had residual tumors with diameters greater than 5 cm. The postoperative increase in sigma S in these cases was not of statistical significance.

Adenocarcinoma↗
PubMed1989

[Forms of treatment and results in invasive vulvar cancer].

Between 1970 and 1982, 113 patients were treated for invasive vulvar cancer in FIGO stages I-IV; 97 patients were available for follow-up. Forty-one patients (42.3%) underwent radical vulvectomy and lymphadenectomy, 21 underwent simple vulvectomy, and 12 (12.4%) had electric resection of the lesion; 42 patients (43.3%) received postoperative radiotherapy. The 5-year survival rate was 61.8% after surgery and radiotherapy. Five-year survival in stages I, II, and III was 85.3%, 60.7%, and 17.9%, respectively. Overall 5-year survival was 52.6%. Patients with small, highly differentiated squamous cell cancers, without lymph node involvement, did best.

Adult↗
PubMed1989

Pelvic and paraaortic lymphocysts after radical surgery because of cervical and ovarian cancer.

To determine the incidence and clinical import of lymphocysts after radical gynecologic surgery including lymphadenectomy, we reviewed the records of 173 patients with cervical cancer and 135 patients with ovarian cancer who were followed up by computed tomography. Lymphocysts were found in 35 (20%) and 43 (32%) of the patients, respectively. Patients with cervical cancer and positive lymph nodes had a significantly higher rate of lymphocyst formation than did those with negative nodes (29% versus 14%, respectively, p less than 0.02). Age, type of lymphadenectomy, volume of fluid furthered by postoperative drains, disease stage, and tumor histology were not related to lymphocyst development. We saw no complications strictly attributable to lymphocysts. The clinical import and treatment possibilities are discussed.

Adenocarcinoma↗
PubMed1989

The spread of ovarian cancer.

Spreading intra-abdominally, ovarian cancer reaches the upper abdomen relatively quickly. Metastases result from the implantation of cells from the primary tumour or, perhaps, may arise de novo from the peritoneal epithelium. The tumour also spreads via the lymphatics directly to the pelvic nodes, directly to the para-aortic nodes, or directly to both. Pelvic nodes were positive in 57.9% of patients of all stages. The highest incidence, 70.4%, was found in Stage III. The percentage of positive para-aortic nodes was lower, namely 50.9% overall incidence and 67.6% in Stage III. Concerning the concomitant involvement of pelvic and para-aortic nodes, 40.4% of patients with positive pelvic nodes also had positive para-aortic nodes. Of patients with negative pelvic nodes, 36.8% also had negative para-aortic nodes. Of all patients, 12.3% had positive pelvic nodes and negative para-aortic nodes. Conversely, 10.5% of all patients had positive para-aortic nodes and negative pelvic nodes. There is a significant association between the involvement of the diaphragm and that of the pelvic and para-aortic nodes. Of those patients with tumour deposits on the diaphragm, 84.4% also had positive retroperitoneal nodes. Conversely, 55.9% of patients with positive nodes also had tumour deposits on the diaphragm. This means that ovarian cancer spreads almost simultaneously in two ways: intra-abdominally and retroperitoneally. Surgical treatment must address both modes.

Female↗
PubMed1989

Prognostic implications of residual tumour volume in stage III ovarian cancer patients undergoing adjuvant cytotoxic chemotherapy.

Despite recent improvements, the survival of patients with advanced ovarian cancer remains unsatisfactory. In our patients who underwent radical debulking surgery, including systematic pelvic (and, additionally, in about one-third, para-aortic lymphadenectomy), the size of residual tumour volume prior to cytotoxic chemotherapy was the most critical single prognostic determinant. The value of complete tumour removal was reflected in the survival curves. Patients with no residual disease following debulking surgery who underwent complete adjuvant chemotherapy showed a significantly better survival than did women with residual tumour burdens (P less than 0.05). The actuarial 1-year survival rate in patients with no RD, RD less than 2 cm, and RD greater than 2 cm was 96%, 88%, and 83%, the 3-year survival rate was 78%, 56%, and 37%, and the 5-year survival rate was 78%, 40%, and 21%, respectively. Our results agree with previous studies. The data underline the need for aggressive debulking, including systematic lymphadenectomy and subsequent chemotherapy. The smaller the initial cell population the smaller the probability of drug-induced resistance. The greater the diameter of a tumour the greater the number of cells which remain in the G0 phase--and which are thus not susceptible to chemotherapeutic compounds.

Adult↗
PubMed1989

The significance of pelvic and para-aortic lymphadenectomy in the operative treatment of ovarian cancer.

Since 1980, 95 of 320 patients with ovarian cancer of Stages I to IV have undergone pelvic lymphadenectomy. A further 57 patients underwent pelvic and para-aortic lymphadenectomy. In the last three years, 83% of patients with Stage III disease had a lymphadenectomy, and 34% had no gross residual tumour after surgery. This entailed bowel resection in 33% of cases. After cytoreduction and chemotherapy, actuarial 5-year survival in Stages I and II was 90%, and was just over 40% in Stage III. Patients with positive nodes had markedly poorer survival than did those with negative nodes. Three years after only pelvic lymphadenectomy, 36.7% of patients with Stage III disease had no clinical, radiological or biochemical evidence of disease. If the abdomen had been cleared of gross disease at surgery, 70% of the patients had no evidence of disease at 3 years. The therapeutic effect of lymphadenectomy is also reflected in the marked improvement in survival of all patients with Stage III ovarian cancer after the introduction of lymphadenectomy.

Chromaffin System↗
PubMed1989

A tumour-marker combination versus second-look surgery in ovarian cancer. I. Clinical experience.

Tumour markers are substances that occur at elevated blood levels in patients with certain tumours. When their specificity and sensitivity are known, markers can be used to monitor cancer patients. No single marker is specific and sensitive for a certain tumour, so that a combination of tumour markers is used. The efficacy of CA125, ferritin, TPA and CEA was demonstrated in 162 patients with ovarian cancer. With the same combination, we found a statistically significant correlation (91.7%) between the clinical course of the disease and the marker profile in 60 further patients. Tumour markers can also help make a prognosis. In 34 patients the marker profile accurately predicted the findings at second-look surgery. Thus, biochemical monitoring may supplant the second-look procedure. Sixty-eight patients were followed for a mean of 2.7 years after completion of chemotherapy. In 95.6% of these cases the tumour-marker analysis correlated with the clinical and radiological course. This means that the end of chemotherapy depends on biochemical monitoring, and second-line therapy can be initiated sooner.

Biomarkers, Tumor↗
PubMed1989

Efficacy of adjuvant carboplatin-epirubicin chemotherapy in advanced ovarian cancer after radical surgery.

Postoperatively, 13 patients with stage III ovarian cancer received a combination of carboplatin and epirubicin (PE) at 300 and 60 mg/m2 respectively. The results of the 13 patients receiving the PE regimen were retrospectively compared to those of 24 patients who received the conventional PAC schedule (cisplatin, Adriamycin and cyclophosphamide at a dosage of 50, 50 and 750 mg/m2, respectively). All 37 patients had undergone radical debulking surgery including pelvic and paraaortic lymphadenectomy. At 8 months, relapse-free rates of 42.2 and 79.2% were observed in the PE and PAC groups, respectively. This difference was highly significant (p = 0.011). The data suggest that the PE combination has less antineoplastic activity than the PAC schedule and thus cannot be recommended in the adjuvant treatment of advanced ovarian cancer.

Adult↗