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Biomedical subjects

U Metzger

Publications and source records attributed to U Metzger.

At least 91 records · Page 5Linked to original sources
PubMed1985

[Prospective follow-up study of radically resected colorectal carcinoma. Status after 5 years].

207 patients curatively resected for colorectal cancer have been followed up in a prospective, controlled study using serial CEA, ultrasound, colonoscopy and clinical examination for early detection of recurrent tumor. After a median follow-up of 2.5 years, 52 recurrences (25%) have been detected, rising CEA value being the most sensitive indicator (86%) among the diagnostic procedures. 26 patients were reoperated for recurrent disease; in 10 out of 19 patients with local and 3 out of 7 patients with distant recurrence a potentially curative resection was possible. Median survival of patients not operated upon (n = 26) or incompletely resected (n = 13) is 8.5 months, whereas median survival for the 13 patients reoperated for cure has not yet been reached at 2 1/2 years. With respect to resectability, thorough clinical examination and endoscopy have been the most sensitive examinations (both 44%). Aggressive follow-up for suitable patients with colorectal cancer will detect most of the recurrences in an early asymptomatic phase, increase the rate of resectability and prolong survival in selected, curatively reresected cases.

Carcinoembryonic Antigen↗
PubMed1985

[Follow-up of potentially cured cancer patients. Object, method and duration?].

The follow-up of potentially cured cancer patients is discussed. After outlining the goals, requirements and problems of posttreatment follow-up, practical guidelines for gastrointestinal, breast and lung cancer, the malignant lymphomas and testicular cancer are suggested for the benefit of the medical practitioner, who often directs the follow-up care of a patient after completion of primary treatment for cancer.

Breast Neoplasms↗
PubMed1985

Interim analysis of a phase III study on preoperative radiation therapy in resectable rectal carcinoma. Trial of the Gastrointestinal Tract Cancer Cooperative Group of the European Organization for Research on Treatment of Cancer (EORTC).

To improve surgical results of potentially operable rectal cancer (T2, T3, T4, Mo), the European Organization for Research on Treatment of Cancer (EORTC) conducted a two-arm randomized clinical trial to evaluate the effect of administering radiotherapy before radical surgery. Four hundred ten patients were allocated to be treated either by surgery alone or by 34.5 Gy of radiotherapy (in 19 days overall) followed by surgery. The tolerance of the adjuvant radiation therapy was fairly good. The 5-year survival rate was 65% overall and showed no difference between both therapeutic regimens. Similarly, the metastases-free rate was the same in both groups. In contrast, the preoperative radiation therapy showed a marked effect on local control of the disease, the comparison of the time to local recurrence being highly significant between the two treatment groups (P = 0.001). The proportion of patients free of local recurrence at 5 years was 85% in the combined treatment versus 65% in the group of patients treated by surgery alone.

Adult↗
PubMed1985

Blood distribution in computer cranial tomograms after subarachnoid hemorrhage with and without an aneurysm on angiography.

This is a comparative study of the blood distribution in computer cranial tomograms after spontaneous subarachnoid hemorrhage in 51 patients with saccular aneurysms and 34 patients with no evidence of a source of bleeding in cerebral panangiography. There was often less blood observed at all sites when aneurysms were not present. This was, however, significant only in the interhemispheric fissure, the Sylvian cisterns, the parietal sulci as well as intracerebrally. Thus, 79.4% of patients without an aneurysm were in grades I and II of the Hunt and Hess scale as opposed to 47.0% of those patients with evidence of an aneurysm.

Adult↗
PubMed1985

[Local recurrence following anterior rectum resection--manual versus stapler suture].

A retrospective study was carried out on 88 hand sewn and 34 stapled anastomoses following anterior resection to evaluate the impact of suture technique on local recurrence rate. The patient groups were comparable with one exception: there were significantly more Dukes C lesions resected and sutured using the stapling gun (35% versus 15%, X2 = 6.33, p less than 0.05). Stage-corrected recurrence rate was similar in both groups, Dukes A: 8%, Dukes B 21%, Dukes C 52%, all recurrences being detected within 24 months following operation. Significantly fewer protective colostomies were needed using the staple gun (15% versus 34%, X2 = 4.50, p less than 0.05). Otherwise, no significant difference or benefit was observed comparing the two suture techniques.

Colonic Neoplasms↗
PubMed1985

The role of surgery in stage IIC and III nonseminomatous testicular cancer.

30 Patients with stage IIC and III nonseminomatous testicular cancer underwent surgery for residual tumor after induction chemotherapy (postinductive surgery). There were no operative deaths and surgical morbidity was not influenced by preoperative chemotherapy. A complete surgical remission was achieved in 9 of 15 patients with mediastinal or pulmonary deposits and in 6 of 12 patients with retroperitoneal metastases. Alphafetoprotein (AFP) levels over 10(4)ng/ml at diagnosis and persistently elevated AFP values preoperatively were associated with failure of surgery to achieve complete remission (p less than .05) and to achieve long-term survival even after surgical complete remission. Fifteen of 17 patients with radical surgery remained disease-free after a median follow-up of 33 months. Six of the 13 relapsing patients had elevated AFP levels prior to definitive surgery. In one patient a contralateral testicular cancer was diagnosed 60 months after postinductive surgery. Of the 17 disease-free survivors, 12 had no tumor, 4 had mature teratoma and only one patient had mature teratoma with malignant foci in the resected surgical specimen. We conclude that AFP levels at diagnosis, elevated AFP prior to definitive surgery, achievement of complete surgical remission and histology of residual tumor are important prognostic factors determining long-term survival in residual stage IIC and III nonseminomatous testicular cancer.

Adolescent↗
PubMed1984

[The Mirizzi syndrome].

Three cases of Mirizzi's syndrome are reported, with special emphasis on differential diagnosis and preoperative evaluation. The syndrome consists of the triad cystic duct stone, inflammatory reaction and benign hepatic duct stenosis. Endoscopic retrograde cholangiography or percutaneous transhepatic cholangiography is mandatory for preoperative evaluation. Cholecystectomy with clearance of the bile duct is the treatment of choice.

Cholecystectomy↗
PubMed1984

Endoscopic follow-up after colorectal cancer surgery. Early detection of local recurrence?

This study deals with 188 consecutive patients who had a radically resected colorectal carcinoma and who were later controlled by colonoscopy. The median interval between resection and endoscopy was 2.5 (0.5-19) years. In 20 patients, a local recurrence was found (10.6%). In 11 of these 20 patients the indication for colonoscopy was the clinical suspicion of a recurrence. The remaining nine patients were asymptomatic, and colonoscopy was done as a routine procedure. In six of nine asymptomatic patients, a potentially curative resection of the recurrent tumor was possible, which was not possible in any of the 11 symptomatic patients. Nineteen of the 20 patients with a local recurrence could be followed up. Five of the six patients with potentially curative resection of the recurrence were asymptomatic for a median time of 38 (12-72) months after surgery; in contrast, 9 of 13 patients without curative operation died after a median survival period of 8 (1-24) months. The results of this study suggest that good long-term prognosis may be expected in patients in whom local recurrence is detected at an early asymptomatic stage with the possibility of potentially curative resection. Therefore, the authors propose regular endoscopic examinations in the first years after curative colorectal cancer surgery.

Adult↗
PubMed1984

[What does computer tomography and abdominal ultrasound studies accomplish in the staging of Hodgkin's disease?].

In a prospective series of 25 patients with early-stage Hodgkin's disease, abdominal assessment by computer tomogram and ultrasound was controlled by staging laparotomy. It was found that the probability of Hodgkin's disease increased with increasing diameter of the abdominal lymph nodes. 42% of the nodes between 16-20 mm in diameter had evidence of disease. Overall accuracy and specificity for the assessment of abdominal lymph nodes by CT and US was around 90%. Sensitivity was much lower than in other series, probably due to the fact that our patient sample was relatively small and consisted of patients in earlier stages with small lymph nodes. Assessment of lymph nodes by US is more, and assessment by CT less, dependent on individual factors. It is concluded that neither CT or US can replace staging laparotomy if precise information about abdominal lymph nodes is needed. Assessment of the spleen by CT and US is usually unreliable and needs histologic confirmation.

Adult↗