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Biomedical subjects

S Ous

Publications and source records attributed to S Ous.

At least 55 records · Page 3Linked to original sources
PubMed1987

Life with an ileal conduit in cystectomized bladder cancer patients: expectations and experience.

Before total cystectomy for bladder cancer 59 patients answered a questionnaire dealing with the "quality of life" they expected after performance of an ileal conduit. Forty-nine relapse-free patients filled in a comparable questionnaire after a median of 36 months following total cystectomy. In the majority of patients the overall "quality of life" was considered as good after total cystectomy though moderate changes of the daily, professional and social life were frequent. Information to the patient before cystectomy must be improved, especially concerning post-operative sexual problems and necessary modifications of social activities (sport, hobbies, travelling). A social worker, a urostomy patient group and a stoma-therapist should all be put in contact with any patient in whom an ileal conduit is planned.

Erectile Dysfunction↗
PubMed1986

DNA flow cytometry in human bladder carcinoma.

The cell kinetic fractions (G0/G1; S; G2 + M) were evaluated by DNA flow cytometry (DNA FCM) in 102 biopsies from bladder carcinoma, previously untreated by cytotoxic therapy, and in 25 biopsies taken at least 3 months after prior treatment (chemotherapy, radiotherapy, surgery). Non-diploid DNA-stemlines were most often found in tumours of a high T category and of a high histopathological grade. Also the number of tumours with a fraction of cells in S-phase above 10% correlated with the clinical stage and histological grade. When the cytotoxic treatment preceded the actual biopsy by 3 months or more the distribution of stemline ploidies in the recurrent or residual tumours were similar to that seen in previously untreated patients. Furthermore, 4 of 5 individual muscle infiltrating bladder tumours treated with surgery, radiotherapy or systemic chemotherapy had the same stemline ploidy before and after treatment. The analysis of ploidy and cell kinetic parameters obtained from DNA FCM offers a possibility to evaluate the prognosis and the therapy effects in human bladder carcinoma.

Aged↗
PubMed1986

Treatment of T2/T3 bladder carcinoma: total cystectomy with and without preoperative irradiation.

Total cystectomy with or without preoperative radiotherapy was performed in 122 patients with T2/T3 bladder carcinoma (group 1:42 patients, 23 X 2 Gy; group 2:34 patients, 5 X 4 Gy; group 3:46 patients, 0 Gy). Crude and disease-free survival was 40 and 54%, respectively, in this retrospective study. No survival difference was observed between the different groups. 'Stage reduction' in the cystectomy specimen (P less than T) was the only significant prognostic parameter and was seen in 24, 15 and 18 patients from groups 1, 2 and 3, respectively. Distant metastases were found in 47 patients during follow-up, equally distributed between the 3 groups, but significantly less often in patients with 'stage reduction'. In patients with T2/T3 bladder cancer, the role of precystectomy radiotherapy remains undefined, though there might be a nonidentifiable subgroup of patients (about 20%) who probably benefit from preoperative irradiation. Preferably short-term radiotherapy should be applied. As distant metastases represent the most common reason for treatment failure after total cystectomy, the role of adjuvant systemic chemotherapy has to be explored in further clinical studies.

Carcinoma↗
PubMed1985

DNA flow cytometry in human testicular cancer.

DNA flow cytometry revealed aneuploid tumour stemlines in 19 of 20 primary testicular cancers without significant difference of the ploidy values between seminomas and non-seminomas. In 7 of 8 analyzable histograms the S-phase activity was 22-51%. A metastatic mature teratoma had 6% cells in S-phase. These results support the clinical observation that testicular cancer is usually a rapidly growing human tumour. The high percentage of aneuploidy in testicular cancer may be of clinical value in the diagnosis of this malignancy.

DNA, Neoplasm↗
PubMed1985

Post-treatment fertility in patients with testicular cancer. I. Influence of retroperitoneal lymph node dissection on ejaculatory potency.

"Dry ejaculation" occurred in none of 15 patients with testicular cancer treated by right-sided retroperitoneal lymph node dissection (RLND). After left-sided and bilateral RLND, "dry ejaculation" was observed in 7/21 and 51/61 men respectively. Twelve of 21 patients with "dry ejaculation" or small volumes of seminal fluid had true retrograde ejaculation. In 7 of 10 men the ejaculatory volume increased significantly after treatment with imipramine chloride. Four men impregnated their wives during treatment with the drug. Without impairing the results of therapy it is possible to spare fibres from the sympathetic chains and pre-sacral plexus during RLND due to testicular cancer, thus preserving fertility in at least 40% of patients.

Adolescent↗
PubMed1985

Post-treatment fertility in patients with testicular cancer. II. Influence of cis-platin-based combination chemotherapy and of retroperitoneal surgery on hormone and sperm cell production.

Active sperm production was observed in 20 of 35 patients with testicular cancer 1 year after discontinuation of all treatment (retroperitoneal surgery only: 13; cis-platin-based chemotherapy (CVB) +/- other treatment: 22). The percentage of patients who regained spermatogenesis increased slightly after a further 1 to 2 years. Fourteen patients (of 121 under observation) impregnated their wives (after retroperitoneal surgery: 9; after CVB +/- other therapy: 5). The individual serum FSH values correlated significantly with the results of sperm analysis: an FSH value greater than or equal to 20 iu/l indicated azoospermia in 8 of 12 patients, whereas only 5 of 30 patients with FSH levels less than or equal to 12 iu/l were azoospermic. Serum testosterone and pituitary serum LH were virtually unaffected by the treatment. In conclusion, 1 to 3 years after cis-platin-based multi-modality treatment for testicular cancer, 50 to 60% of patients have active spermatogenesis and fatherhood can be achieved by a significant number of them.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Prediction of tumour progression in superficial bladder carcinoma.

In a retrospective study, prognostic factors have been analyzed in 45 patients with superficial bladder carcinoma (Tis, Ta, T1) with subsequent progression to invasive (T2, T3, T4) and/or metastatic (M+) disease. The findings are compared with those from a control group of 17 patients with no subsequent invasive or metastatic disease. In a single-parameter analysis the following parameters were significantly associated with a high risk of developing invasive disease: tumour multiplicity; tumour invasion of blood and/or lymph vessels; increasing histological grade, and the history of previous surgical treatment. In a multivariate analysis, multifocality, small vessel infiltration and previous treatment per time (TPT factor) were significantly related to the risk of subsequent progression. An arbitrary score system revealed that progression could be predicted significantly in patients with a high score.

Aged↗
PubMed1985

Short-term and long-term effect of prophylactic treatment of superficial bladder cancer with intravesical adriamycin.

37 patients with recurrent Ta/T1 bladder cancer were treated with intravesical adriamycin (80 mg monthly) after complete TUR (1977-1979). Within a minimum follow-up of 5 years, 11 of them developed evidence of progression - muscle invasion or distant metastases. 8 of them have died of bladder cancer. Ten patients showed a complete response to adriamycin therapy, developing no new tumors during the period of treatment (1 year). One of them developed distant metastases. The remaining 27 patients continued to develop recurrences, despite adriamycin therapy, though the recurrence rate was reduced by at least 50% in 5 of them. The risk of progression and death remains high if the patient continues to have recurrences, even in cases in which the recurrence rate is apparently reduced. Recurrent superficial bladder cancer remains a dangerous disease. The prognosis is good if recurrences cease altogether during prophylactic intravesical adriamycin treatment.

Aged↗
PubMed1984

Carcinoma of the prostate with soft tissue or non-regional lymphatic metastases at the time of diagnosis: a review of 47 cases.

The clinical course of 47 patients with carcinoma of the prostate who at the time of initial presentation had metastases to soft tissue or non-regional lymph nodes was retrospectively reviewed. The response rate to primary hormonal treatment (orchiectomy or oestrogens) and the duration of response were similar to those of 47 other patients presenting with skeletal metastases only. The survival of the patients in the study group was not statistically different from that of patients with skeletal metastases only. The results suggest that patients presenting initially with metastases to non-regional lymph nodes or soft tissue should be treated by the same therapeutic methods as for disseminated prostatic cancer in general (oestrogens or orchiectomy). Slight or no urinary symptoms at the time of initial presentation in spite of a locally advanced tumour was a common finding; 20% of the patients had normal serum prostatic acid phosphatase despite the presence of disseminated disease. Lymph node enlargement in the left supraclavicular fossa was the most common site of non-regional lymphatic spread. Elderly males with metastatic carcinoma in this region should be investigated for the possibility of prostatic cancer.

Adult↗
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↗
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↗
PubMed1983

The role of CT in demonstrating perivesical tumor growth in the preoperative staging of carcinoma of the urinary bladder.

Carcinoma of the urinary bladder was staged both clinically and by CT in 32 patients before they underwent total cystectomy. Eleven of the patients had perivesical growth demonstrated at histopathological examination of the cystectomy specimen. This was diagnosed by CT in all 11 of these patients before cystectomy, but it was discovered by clinical staging in only four patients prior to cystectomy. Seven patients without histopathologically proved perivesical growth were considered to have perivesical spread as demonstrated by CT findings. Three of these patients had perivesical fibrosis that was misinterpreted as perivesical tumor growth, and in all seven patients the perivesical changes were adjacent to the area of present or previous changes in the bladder wall. CT is a valuable addition to clinical staging because it demonstrates perivesical tumor growth.

Carcinoma↗
PubMed1983

Clinical significance of routine follow-up examinations in patients with metastatic cancer of the prostate under hormone treatment.

The results of clinical examination, skeletal X-ray, bone scan and phosphatase determinations in serum were analyzed in 30 patients with metastatic prostatic cancer prior to and during anti-androgenic treatment. Bone scan revealed skeletal metastases in all 30 patients, whereas X-ray showed bone metastases in only 22 patients. Radiological pseudoprogression and scintigraphic flair reaction were relatively frequent findings during the first 3-8 months of effective hormone therapy. Later on progressive changes on X-ray and bone scan were well related to clinical progression of the disease and indicated a poor prognosis in the individual patient. Soft tissue metastases most often responded well to the initial hormone treatment, but regrew only rarely during later disease progression. Changes of the radioimmunologically determined prostatic acid phosphatase seemed most often to indicate the presence of advanced disease and subsequent disease progression. Second line treatment of hormone-unresponsive prostatic cancer is at best palliative and has not been proved to prolong the survival in most of the patients. In routine clinical practice, the need for such second line therapy is dependent on the patient's symptoms and not on the early detection of progressive changes on X-ray, bone scan or blood tests. Therefore it seems unnecessary to perform these examinations regularly in hormone-treated asymptomatic patients with advanced prostatic cancer unless the patient is entered into a clinical research program.

Acid Phosphatase↗