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Biomedical subjects

M S Piver

Publications and source records attributed to M S Piver.

At least 145 records · Page 8Linked to original sources
PubMed1989

Weekly cisplatin induction chemotherapy in the treatment of recurrent cervical carcinoma.

Sixty-nine patients with recurrent cervical carcinoma were treated with weekly cisplatin induction chemotherapy. A 27% objective response was obtained in 67 evaluable patients. The highest responses were seen in liver (33%), supraclavicular nodes (40%), and lung (48%), whereas only one out of 24 (4.2%) patients with central recurrence responded. Consolidation therapy with cisplatin combinations administered on a monthly basis did not enhance response to cisplatin. Cisplatin induction therapy was well tolerated with minimal toxicity.

Adenocarcinoma↗
PubMed1989

Synthesis and release of glycoconjugates bearing N-linked oligosaccharides by ovarian carcinoma cells isolated from effusions.

Ovarian carcinoma cell clusters were isolated from patient effusions. The cell isolates were incubated in vitro with radioactive glycoconjugate precursors. Radiolabelled glycoconjugates released to culture media were analyzed for molecular mass heterogeneity and lectin binding activity. From 10 to 50% of the released glycoconjugates were present as a heterogeneous array of glycoconjugates of molecular mass greater than 250 kilodaltons. The remaining glycoconjugates were dispersed in a molecular mass range extending down to approximately 15 kilodaltons. Concanavalin A-Sepharose affinity chromatography revealed the presence of N-linked oligosaccharides. Interaction of glycoconjugates with lentil and pea lectins indicated the presence of L-fucose residues linked to asparagine-bound N-acetylglucosamine. Precipitation of glycoconjugates with ricinus communis agglutinin I showed the presence of nonreducing terminal N-acetyllactosamine residues. Collectively, the data indicate that ovarian carcinoma cells release to culture medium fucosylated glycoconjugates bearing complex-type oligosaccharides. The synthesis and release of these glycoconjugates showed no significant differences among different histologic types of ovarian carcinoma; however, modulation as a function of tumor progression may occur.

Cell Separation↗
PubMed1989

Pathologic complete response of advanced ovarian mixed mesodermal tumor to cisplatin, adriamycin and dacarbazine: a case report.

Presented is a case report of a stage IIIC primary ovarian mixed mesodermal tumor with gross residual disease following aggressive cytoreductive surgery. Following twelve courses of Cisplatin, Adriamycin and Dacarbazine, second-look laparotomy confirmed a pathologic complete response. The patient is now free of disease at 17+ months.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Neoplasms.

Explore the source record for details and available documents.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1989

Fatal recurrent reexpansion pulmonary edema.

A case is reported of fatal recurrent unilateral reexpansion pulmonary edema following thoracentesis in a woman with stage IV ovarian adenocarcinoma. Reexpansion pulmonary edema is a rare complication resulting from reexpansion of a collapsed lung after treatment of pleural effusion, pneumothorax, or atelectasis. The etiology is unknown, and there are no guaranteed measures of prevention. The clinical presentation varies from asymptomatic to rapidly progressive fatal pulmonary edema. The diagnosis is established by chest x-ray. Depending on the severity of the clinical symptoms, treatment varies from monitoring with serial chest x-rays to mechanical ventilation. Reexpansion pulmonary edema is fatal in 20% of cases. Gynecologists should be aware of this rare entity because it may require immediate diagnosis and aggressive treatment.

Cystadenocarcinoma↗
PubMed1989

Synthesis and release of glycoconjugates in vitro by human ovarian carcinoma cells isolated from effusions.

Human ovarian carcinoma cells were isolated as multicellular aggregates from patient effusions. Freshly isolated cells were incubated with radioactive glycoconjugate precursors and the glycoconjugates released to culture medium were analyzed. The glycoconjugates appeared to contain both O- and N-linked oligosaccharides. Both fucosylation and sialylation of glycoconjugates occurred. The results of SDS-PAGE analysis showed the presence of a very heterogeneous array of glycoconjugates with no discrete components resolved. The results of glycoconjugate analyses were independent of carcinoma histology, differentiation, progression, and patient chemotherapy. In contrast, mesothelial cells synthesized a major glycoconjugate of molecular mass 65 KDa. The heterogeneous array of carcinoma-derived glycoconjugates may be transformation-related and may have utility in tumor diagnosis and prognosis.

Carbon Radioisotopes↗
PubMed1989

Patient-controlled analgesia in gynecologic oncology. A comparative analysis.

Patient-controlled analgesia (PCA) allows postoperative gynecologic oncology patients to self-administer intravenous analgesia but has not been well compared to standard intramuscular analgesia. Seventy patients undergoing laparotomy were treated with meperidine via PCA or intramuscular administration and evaluated 24 and 48 hours postoperatively. The 35 patients receiving PCA used statistically significantly less meperidine than did the controls at 24 and 48 hours postoperatively. The pharmacy's cost of the drug was statistically significantly less for PCA patients. PCA meperidine was well tolerated, with minimal alterations in consciousness and infrequent nausea.

Diagnosis, Differential↗
PubMed1988

Stage I uterine adenosarcoma: a report of six cases.

Six cases of Stage I adenosarcoma of the uterus are reported. Although these neoplasms have generally been regarded as being of low malignant potential with little propensity for distant metastasis, our experience reveals some of them to be aggressive tumors with rapid clinical demise. Five (83%) patients demonstrated recurrence after initial surgery, three despite postoperative vaginal radium or external pelvic radiation. Four of the recurrences occurred in the pelvis and abdomen; the fifth was limited to the vagina. Three patients were dead of disease within three years of diagnosis, two of whom achieved clinical remission for at least one year to combination chemotherapy. One of the remaining three patients died from intercurrent disease without recurrence, and two are alive without disease after treatment for recurrence. Based on this limited experience, we believe these neoplasms should be regarded as potentially as malignant as their mixed Müllerian counterpart.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Effect of adjuvant chemotherapy on time to recurrence and survival of stage I uterine sarcomas.

We have evaluated the effect of adjuvant chemotherapy on time to recurrence and survival in two prospective trials of women with stage I uterine sarcomas. The first trial compared surgery only to surgery plus Adriamycin. The 5-year estimated survival rate was 36% for surgery alone and 63% for surgery plus Adriamycin. The 5-year recurrence free rate for surgery alone was 46% as compared to 75% for surgery plus Adriamycin. The second trial, without a concurrent control group, included patients with stage I uterine sarcoma and adjuvant cyclaphosphamide, vincristine, Adriamycin, and dacarbazine (CYVADIC) chemotherapy. The 5-year survival rate was 89% and the recurrence-free rate was 80%. In all of these trials, as well as in the report of Van Nagell et al (Cancer 57:1451-1454, 1986) of adjuvant vincristine, actinomycin-D, and cyclophosphamide (VAC) chemotherapy, there are too few patients to make any formal statistical comparison of the groups, although the surgery plus CYVADIC group appears to be the most promising.

Adult↗
PubMed1988

Conservative therapy for melanoma of the vulva.

Recent cooperative studies have demonstrated that less radical local resection of cutaneous melanomas is equally effective as a traditional radical approach. A retrospective review of vulvar melanoma was undertaken to determine if mode of therapy affected recurrence. Survival correlated independently with depth of invasion and age (p = 0.05 and p less than 0.02, respectively). In the comparison of radical vulvectomy with local excision, no patient differences in age or histopathologic variables were determined (nodal disease status, histology, mitotic count, lymphocytic infiltration, or ulceration). Radical vulvectomy did not improve survival over local therapy (p greater than 0.2). Six of eight patients whose melanoma had less than 2 mm of invasion treated with local therapy are disease free after a median of 127 months (range 6 to 300 months). For local excision, recurrences were more frequent when margins were less than 2 cm, but this was not statistically significant in this small sample. Although the current series is small and retrospective, its findings suggest that treatment recommendations of large cutaneous nonvulvar melanoma studies are applicable to vulvar melanoma. A prospective randomized study of radical versus conservative surgery for vulvar melanoma will be necessary to confirm these treatment recommendations.

Adult↗
PubMed1988

Serum alpha 1-acid glycoprotein in epithelial ovarian cancer.

Fifty-six patients with ovarian adenocarcinoma receiving chemotherapy were monitored with serum alpha 1-acid glycoprotein (AGP) levels. The mean and standard deviation of serum AGP levels for 63 healthy controls were 0.88 +/- 0.469 mg/ml. A serum level above 1.80 mg/ml was considered as above normal level. Five patients had evidence of persistent ovarian carcinoma and had elevated AGP levels. Sixteen patients had normal serum AGP levels and had no evidence of persistent ovarian cancer at second-look laparotomy. However, 35 patients had false-negative AGP levels at the time they had persistent tumor. Although the specificity of the AGP level was 100%, the sensitivity was only 12.5% and the overall accuracy 37%. Therefore, it would appear that serum AGP levels are not of value in monitoring patients with ovarian adenocarcinoma.

Adenocarcinoma↗
PubMed1988

Peritoneal papillary carcinoma.

Between 1977 and 1986, 325 patients with a diagnosis of ovarian carcinoma, peritoneal cancer, or malignant mesothelioma were reviewed with identification of 23 patients (7%) having peritoneal papillary cancer. Only 2 patients had disease confined to the pelvis and the rest had widespread abdominal disease. Various combination chemotherapeutic agents were used with over a 65% response rate to first-line chemotherapy. Twenty of the 23 patients received cisplatin combination chemotherapy with an overall response rate of 65%.

Adolescent↗
PubMed1988

Radical hysterectomy and pelvic lymphadenectomy versus radiation therapy for small (less than or equal to 3 cm) stage IB cervical carcinoma.

One hundred and three women with FIGO stage IB cervical carcinoma were treated either by radical hysterectomy and bilateral pelvic lymphadenectomy, or external pelvic radiation and intracavitary brachytherapy to deliver greater than or equal to 6000 rads to point A. Surgical therapy was to be limited to stage IB tumors measuring less than or equal to 3 cm in greatest diameter, Patients with lesions greater than 3 cm, medical contraindications to surgery, or advanced age were to be treated by radiation therapy. Of the 55 women treated surgically, 3 (5.6%) were found on final histologic evaluation to have tumors greater than 3 cm. The 5-year estimated disease-free interval was 92.3% for patients treated by surgery and 91.1% for patients treated by radiation therapy. Similar rates were achieved for the 5-year disease-free interval for lesions greater than 1 cm, 1-3 cm, and less than 3 cm in diameter by either surgery or radiation. It is tentatively concluded that radical hysterectomy and pelvic lymphadenectomy or radiation therapy as outlined above provide equally good disease-free intervals for stage IB cervical tumors measuring less than or equal to 3 cm in diameter. Because of a bias against patients treated with radiation, it is possible that radiation could lead to better results than surgery in comparable (younger, healthier, thinner) population. The advantage of surgical treatment in the younger patient is preservation of ovarian function.

Adolescent↗
PubMed1988

Five and ten year estimated survival and disease-free rates after intraperitoneal chromic phosphate; stage I ovarian adenocarcinoma.

From 1975 to 1982, 25 evaluable patients with FIGO Stage I ovarian cancer were treated with intraperitoneal chromic phosphate (32P). All patients underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy with (28%) or without (72%) omentectomy, with no other surgical staging procedures prior to referral. Patients were restaged by laparoscopy (inspection of diaphragms, abdomen, and pelvis), biopsy of suspicious lesions, and peritoneal cytologic washings prior to intraperitoneal chromic phosphate therapy. For the 25 patients, the estimated 5- and 10-year recurrence-free rates and the 5- and 10-year survival rates are 84% and 75%, respectively. Excellent 10-year recurrence-free rates were achieved for Stages IA and IC, nonruptured cysts, and Grade I and II tumors. In contrast, very low 10-year survival rates were achieved for patients with Stage IB, ruptured cysts, or Grade III tumors.

Adenocarcinoma↗
PubMed1988

Surgically documented response to intraperitoneal cisplatin, cytarabine, and bleomycin after intravenous cisplatin-based chemotherapy in advanced ovarian adenocarcinoma.

Thirty-one evaluable patients with stages III and IV invasive ovarian adenocarcinoma were treated on a phase II protocol of second-line intraperitoneal cisplatin, cytarabine, and bleomycin. All 31 patients received first-line intravenous (IV) cisplatin-based chemotherapy; the size of the residual cancer was documented surgically before intraperitoneal chemotherapy in all patients. Response to intraperitoneal chemotherapy was documented by a third-look laparotomy in all patients not evidencing progression of disease clinically. There were eight responses (26%): five surgical complete responses and three surgical partial responses. Responders were patients with stage III ovarian cancer, small residual disease of less than or equal to 1 cm (primarily less than or equal to 5 mm), and patients who previously had responded to cisplatin-based IV chemotherapy. Of the 15 patients with stage III ovarian cancer, residual disease less than or equal to 1 cm, and those who had responded to first-line IV cisplatin-based chemotherapy, 53% (eight) responded to second-line intraperitoneal chemotherapy. Intraperitoneal chemotherapy as used in this phase II protocol would appear to be an effective second-line treatment in advanced ovarian cancer in this specific subset of patients.

Adenocarcinoma↗
PubMed1988

The impact of aggressive debulking surgery and cisplatin-based chemotherapy on progression-free survival in stage III and IV ovarian carcinoma.

Forty consecutive patients with stage III and IV invasive ovarian carcinoma were treated on a phase II protocol consisting of optimal debulking surgery, induction cisplatin, cisplatin, doxorubicin, and cyclophosphamide (PAC) chemotherapy, 6-month interval laparoscopy, reinduction cisplatin, PAC chemotherapy, and second-look procedure. All 40 patients have either disease progression or have completed the 12-month protocol. Eighty-seven percent of the patients (35) underwent optimal (less than or equal to 2 cm residual) debulking surgery before chemotherapy, in spite of the fact that 50% (20) were referred to Roswell Park Memorial Institute (RPMI) as inoperable after initial surgery elsewhere. There were no postoperative deaths and chemotherapy was started in less than or equal to 14 days in 97% of the patients. Of the 40 patients, 30% (12) achieved a pathologic complete remission (11) or a clinical complete remission (one patient refused second-look surgery). The estimated 3-year survival rate was 62%, but the 3-year progression-free survival rate was only 29%. The median survival time was 48 months. The estimated 3-year progression-free survival rate was 31% for residual disease less than or equal to 2 cm. For the five patients with residual disease greater than 2 cm, four died within 3 years. The median survival time of patients with less than or equal to 2 cm residual disease was 48 months, as compared with 21 months for those with greater than 2 cm residual disease. Although the estimated 3-year survival rate of 62% is noteworthy, the 3-year progression-free survival rate of only 29% is probably indicative that in spite of extensive debulking surgery and cisplatin-based chemotherapy as used in this protocol, the long range proportion of patients "cured" will remain small.

Adenocarcinoma↗
PubMed1988

Treatment of metastatic lipid cell tumor of the ovary with BV-CAP and VAC chemotherapy, using serum testosterone and dihydrotestosterone as tumor markers.

A metastatic ovarian lipid cell tumor was treated with BV-CAP chemotherapy following cytoreductive surgery and VAC chemotherapy for persistent disease found at second-look laparotomy before disease progression was noted. Serum Dihydrotestosterone (DHT) levels correlated with disease status during all phases of treatment, as did serum testosterone (T) to a lesser degree. Measurement of these two hormones may provide additional useful information on the response of patients with subclinical metastatic disease to post-operative therapy.

Antineoplastic Combined Chemotherapy Protocols↗