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Biomedical subjects

O Klepp

Publications and source records attributed to O Klepp.

At least 55 records · Page 3Linked to original sources
PubMed1984

Unilateral retroperitoneal lymph node dissection in patients with non-seminomatous testicular tumor in clinical stage I.

19 of 53 patients (36%) with non-seminomatous testicular cancer, clinical stage I (CS I), had retroperitoneal lymph node metastases, pathological stage II (PS II), demonstrated by retroperitoneal lymph node dissection (RLND). RLND was done unilaterally in peroperatively tumor-free patients (PS I: 34 patients; PS II: 3 patients) and bilaterally if metastatic lymph nodes were found peroperatively. Patients with PS II received adjuvant cis-platinum containing combination chemotherapy. Postoperative tumor activity was observed in 3 patients (median observation time: 31 months). They were cured by salvage chemotherapy. 12-18 months after RLND no ejaculatory disturbances were observed in 28 of 36 unilaterally operated patients. After unilateral RLND, 7 patients fathered children. Unilateral RLND seems to be a sufficient diagnostic procedure in patients with non-seminomatous testicular cancer, CS I, who were found tumor-free during the operation. Fertility is preserved in the majority of the unilaterally operated patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Multi-modality treatment of advanced malignant germ cell tumours in males. I. Experience with cis-platinum-based combination chemotherapy.

Three-weekly cis-platinum-based combination chemotherapy with or without subsequent surgery and/or radiotherapy resulted in a 58% 3-year-survival in 79 patients with advanced malignant germ cell tumours. Poor risk factors were relapse after previous chemotherapy, retroperitoneal bulky disease, liver metastases and extremely high serum levels of AFP, beta-HCG, and LDH. Patients with pure seminoma had a high curation rate. The overall toxicity was acceptable. Cis-platinum-based chemotherapy is at present the most effective cytotoxic treatment for patients with advanced malignant germ cell tumours. The relatively low survival rate in poor-risk patients necessitates more aggressive primary chemotherapy in this subgroup of patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Multi-modality treatment in males with advanced malignant germ cell tumours. II. Experience with surgery and radiotherapy following cis-platinum-based chemotherapy.

After chemotherapy with cis-platinum, vinblastine and bleomycin, 33 surgical procedures were performed in 29 patients with advanced malignant germ-cell tumours. The tumour masses could be completely resected macroscopically in 26 patients. Histology of the operation specimens showed fibrosis/necrosis (9 specimens), mature teratome (13 specimens) and vital malignant tumour (11 specimens). Patients with fibrosis/necrosis or completely resected mature teratoma had an excellent prognosis, whereas only 5 of the 11 patients with vital malignant tumour survived in spite of second-line treatment with chemotherapy/radiotherapy. Preoperatively elevated serum levels of AFP, beta-HCG and/or LDH indicated the presence of residual vital malignant germ cell tumour. Eight of 14 patients were rendered tumour-free by radiotherapy given as second- or third-line treatment. In general, tumour masses, remaining after cis-platinum-based induction chemotherapy should be resected as completely as possible even in the case of mature teratoma or fibrosis/necrosis. Radiotherapy should be considered as second- and third-line treatment in selected patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Radiation therapy for brain metastases from malignant melanoma.

Thirty-nine patients who completed whole-brain irradiation treatment for brain metastases from malignant melanoma were analyzed. Median survival was 2 months, mean survival 4 months. Only 3 patients survived for 1 year, the longest survival being 19 months after irradiation. Twenty-one (53.8%) showed marked clinical improvement and 6 (40%) of the 15 evaluable patients had some objective regression of the brain metastases. A treatment of 7 fractions of 4.8 Gy in 9 to 14 days and concomitant chemotherapy with dacarbazine and lomustine in 16 patients was well tolerated. This seems to be a beneficial treatment for patients with a comparatively small intracranial tumour burden.

Adult↗
PubMed1984

Treatment with secretin and a cholecystokinin-like peptide in patients with pancreatic cancer. A pilot study.

Secretin and cholecystokinin (CCK) have trophic effects on the pancreas and may therefore have a place in the treatment of pancreatic cancer. The present study was performed to examine whether these hormones may cause harm in patients with pancreatic cancer receiving cytostatics. The cytostatics were 5-fluorouracil, adriamycin, and mitomycin C(FAM). Secretin plus Thr28Nle31CCK25-33, in doses stimulating pancreatic secretion to about 60% of maximal, were given as a continuous 6-day intravenous infusion just before (four patients) or immediately after (five patients) starting treatment with FAM. Five patients received FAM only. When considering symptoms, laboratory findings, abdominal CT scans, and survival, no evidence was found that secretin and CCK may cause serious or unpleasant side effects in patients with pancreatic cancer receiving cytostatics.

Adenocarcinoma↗
PubMed1983

Serum lactate dehydrogenase (S-LDH) and S-LDH isoenzymes in patients with testicular germ cell tumors.

The activities of serum lactate dehydrogenase (S-LDH) and S-LDH isoenzymes were determined in 252 patients with a history of testicular germ cell tumors (TGCT). Fifteen of 37 patients with TGCT lesions and seven of 215 without had raised levels of S-LDH (above 8.0 mukat/l (480 U/l)). Of the patients with TGCT lesions, four had only raised S-LDH-1 levels, one only raised S-LDH-2 (and normal S-LDH), two only raised S-LDH-3 (one with normal S-LDH), and 10 had five combinations of raised levels of S-LDH isoenzymes with a predominance of S-LDH-1. S-LDH and S-LDH-1 correlated significantly with the total tumor volume in the patients with TGCT lesions, especially pronounced in those with lesions from seminoma. Of 34 patients with TGCT metastases, 13 with raised S-LDH levels lived significantly shorter lengths of time than 21 with normal S-LDH. Similarly, 11 with raised S-LDH-1 (above 3.0 mukat/l (180 U/l) lived significantly shorter times than 23 with normal S-LDH-1. S-LDH is a valuable tumor marker in patients with TGCT, especially in those with seminoma. Routine determination of S-LDH isoenzymes in addition to S-LDH in patients with TGCT is not recommended. In patients with a history of TGCT and an unexplained elevation of S-LDH levels, a raised S-LDH-1 level indicates the presence of TGCT lesions.

Chorionic Gonadotropin↗
PubMed1983

Phase II study of amsacrine in solid tumors: a report of the EORTC Early Clinical Trial-Group.

A total of 239 patients with advanced solid tumors were treated in this phase II trial. Amsacrine was administered as a single i.v. dose of 120 mg/m2 repeated at 21-day intervals. The initial dose was reduced to 90 mg/m2 in the case of extensive prior therapy. Some antitumor activity was detected in head and neck cancer but the drug appears to lack significant efficacy in epidermoid lung cancer as well as in carcinoma of the breast, melanoma, renal cell cancer, colorectal cancer and non-seminomatous testicular cancer. Leukopenia was the major toxic effect encountered in this trial and was similar at 90 and 120 mg/m2.

Adult↗
PubMed1983

Comparison of computed tomography, lymphography, and phlebography in 200 consecutive patients with regard to retroperitoneal metastases from testicular tumor.

Two hundred patients with testicular tumor were examined by computed tomography (CT), lymphography, and phlebography of the inferior vena cava and left renal and testicular veins. Metastases were demonstrated in 71. CT was positive in 66, lymphography in 60, phlebography in 53, and a combination of lymphography and phlebography in 65. CT was particularly helpful in studying the upper retroperitoneal space and defining the extent of tumor. Lymphography was preferable for demonstrating metastases in non-enlarged, contrast-filled nodes. Phlebography was never the only positive examination and is not recommended as a routine procedure, though it may be helpful in planning surgery. The authors suggest that CT be performed first, followed by lymphography in negative or equivocal cases.

Adolescent↗
PubMed1982

The risk of spontaneous pneumothorax in patients with osteogenic sarcoma and testicular cancer.

Seven cases of unilateral, spontaneous pneumothorax were found in a retrospective study of 63 patients with osteogenic sarcoma who were admitted to The Norwegian Radium Hospital (NRH) in the period 1970--1977. The relative risk of pneumothorax developing doubled, from 7--14%, after the introduction of chemotherapy for this disease at NRH. This difference was not statistically significant. Pneumothorax developed in two of 18 patients (11%) with lung metastases who never received chemotherapy. Pneumothorax occurred in four of 19 patients (21%) treated with chemotherapy for manifest lung metastases, and in one of eight patients (13%) who received adjuvant chemotherapy, but in whom lung metastases developed later. Pneumothorax did not develop in 79 patients treated with chemotherapy for disseminated testicular cancer, despite the fact that 82% of these patients had manifest lung metastases.

Adolescent↗
PubMed1980

Testicular function after combined chemotherapy for metastatic testicular cancer.

In 10 patients cured for metastatic testicular cancer by combination chemotherapy serum hormone levels and serum agglutinating antibodies were analysed 12 to 35 months after discontinuation of the treatment. Together with these examinations sperm analysis was done. All patients had increased levels of follicle stimulating hormone (FSH). Serum testosterone was usually in the lower part of the normal range (below 20 nmol/l). In eight patients the serum agglutinating antibodies were normal, while two patients had increased levels. In all patients azoospermia was observed, indicating long-lasting infertility in patients testicular cancer treated by combination chemotherapy. The possible importance of cryopreservation prior to start of chemotherapy is discussed.

Follicle Stimulating Hormone↗
PubMed1980

Endocrinological studies in patients with metastatic malignant testicular germ cell tumours.

In this study, various serum hormone levels were determined in patients with metastatic testicular germ cell tumours. Raised LH levels, due to a cross reaction with hCG in the radioimmunoassay, were observed in 20 out of 29 patients with active disease and were mainly caused by gonadotrophin production in the tumour tissue. Increased LH levels were frequently observed in the patients with non-seminomatous tumours, but were also found in 4 (out of 6) patients with metastatic seminoma. One should, however, preferably use a specific hCG radioimmunoassay in order to measure tumour hCG as a tumour marker with a high diagnostic accuracy. In patients with active disease despite ongoing combination chemotherapy which included LH suppressing medication, serum testosterone remained above 6 nmol/l in 11 out of 16 patients. These patients remained sexually potent, while testosterone values below 6 nmol/l usually were combined with sexual impotence in patients during combination chemotherapy. These data strongly suggest that the tumour hCG has a biological activity, stimulating the remaining testis to increased testosterone secretion in these patients. The serum E2-17 beta levels were slightly to moderately increased in half of the patients with metastatic disease. Markedly increased serum E2-17 beta levels (> 0.30 nmol/l) and very high prolactin values (> 32 micrograms/l) were observed only in patients with high LH levels (> 9.5 micrograms/l) and a large tumour burden. These observations indicate that E2-17 beta and prolactin determinations are of minor value for early detection of tumour manifestations. Serum FSH cannot serve as a tumour marker in patients with testicular germ cell tumours.

Adult↗