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Biomedical subjects

Z Wajsman

Publications and source records attributed to Z Wajsman.

At least 73 records · Page 4Linked to original sources
PubMed1983

Treatment of sequential bilateral germ cell tumors of the testis following interval retroperitoneal lymph node dissection.

Modification in lymphatic drainage following retroperitoneal lymph node dissection, such as a collateral circulation or lymph node and lymphatic vessel regeneration, was observed in 2 patients in whom a second tumor developed in the remaining testicle. Such alterations of the lymphatic system are difficult to evaluate for the possible presence of metastatic disease. The presence of extensive collateral circulation rules out lymph node dissection or radiation therapy as an appropriate treatment in these patients. A short course of systemic chemotherapy, regardless of the histological type of the second malignancy, seems to be the safest adjunctive treatment in such cases.

Adult↗
PubMed1983

Severely contracted bladder following intravesical mitomycin C therapy.

Most superficial bladder tumors are best treated by transurethral resection. However, because of their multifocal origin and high rate of recurrence they often present challenging therapeutic problems. Intravesical chemotherapy often is used in such cases in the treatment and prevention of recurrent transitional cell carcinoma of the bladder. Recently, mitomycin C intravesical chemotherapy was shown to be effective in the treatment of superficial bladder tumors. No systemic toxicities were described but bladder irritation and drug-related palmar desquamation were noted. We report a case of a severely contracted bladder requiring urinary diversion following intravesical chemotherapy with mitomycin C. A possible relationship of this complication to the mitomycin C treatment is suggested.

Aged↗
PubMed1983

Changing concepts in the treatment of advanced seminomatous tumors.

The treatment of patients with advanced seminomatous tumors represents a challenge for the medical and urological oncologists. In contrast to the reported excellent results of radiotherapy in the treatment of patients with clinical stages I and II disease the survival rate for those with advanced seminomatous disease is only around 40 per cent. Six consecutive patients with metastatic seminomas were treated with systemic chemotherapy and all achieved a complete response. The combination of vincristine, cis-platinum, bleomycin and prednisone was used in 4 patients and an excellent tolerance was observed even in patients with previous radiation therapy. Two other patients who had had radiation therapy to the mediastinum were treated with VP-16 and cis-platinum and again a complete response was observed. However, a significant potentiation of myelosuppressive effect of VP-16 was observed in the previously radiated patients. In view of the observed sensitivity of seminomatous tumors it appears that all patients who present initially with metastatic or bulky retroperitoneal disease should be treated with multiple drug chemotherapy and cytoreductive surgery similar to the treatment modalities used for nonseminomatous germ cell tumors. Radiation therapy for patients with this stage of the disease seems to be not only ineffective but also may compromise the benefits of aggressive chemotherapy.

Adult↗
PubMed1983

Filling of the obturator nodes in pedal lymphangiography: fact or fiction.

The value of pedal lymphangiography as a staging procedure for carcinoma of the prostate and the bladder continues to be debated because of the fact that the obturator lymph nodes apparently are not visualized during this diagnostic technique. This study involves 25 patients who have undergone pedal lymphangiography followed by fine needle aspiration. Pelvic lymph node dissection was performed and pelvic x-rays were taken once the external iliac nodes had been excised, leaving the obturator nodes behind. The next step was the removal of the remaining nodes in the obturator fossa, after which another x-ray was obtained. With this technique we could prove whether these obturator lymph nodes opacified on routine pelvic x-ray. In a review of the radiography consistent filling of the obturator nodal chain was noted in all of the cases, as well as the consistent prediction of the location of these lymph nodes before fine needle aspiration.

Genital Neoplasms, Male↗
PubMed1982

High-dose tamoxifen in metastatic renal cell carcinoma.

The effectiveness of high-dose Tamoxifen in the treatment of metastatic renal cell carcinoma was evaluated. Fifteen patients were treated for eight weeks with 80 mg of Tamoxifen daily. Side effect were minimal. Results showed progression of disease in 47 per cent of the patients, no change in disease was seen in 40 per cent, and 13 per cent showed a partial objective response. Twenty per cent of patients showed deterioration of performance status. High-dose Tamoxifen does not appear to be useful in the treatment of advanced renal cell carcinoma.

Adenocarcinoma↗
PubMed1982

Fine-needle aspiration of metastatic lesions and regional lymph nodes in genitourinary cancer.

A percutaneous fine-needle aspiration biopsy of metastatic tumor and/or retroperitoneal, pelvic, or abdominal lymph nodes was accomplished in 101 patients. A diagnosis of metastatic disease was confirmed by this method in 49 patients. In 26 patients, surgical excisional biopsy or exploratory laparotomy was avoided. An unknown pelvic mass causation was diagnosed in 3 patients. In 15 of 57 patients with localized bladder, prostate, or testis cancer, involvement of regional lymph nodes was confirmed by transabdominal find-needle aspiration. All 57 transabdominal aspirations were performed without complications. The method is inexpensive, safe, and can have a high accuracy in diagnosing a local tumor spread or distant metastases.

Abdomen↗
PubMed1982

Transverse colon conduit: a method of urinary diversion after pelvic irradiation.

Patients with pelvic malignancies often require irradiation as part of the treatment protocol or as definitive treatment for the malignancy. Subsequent urinary diversion with the low lying small bowel or the descending colon often results in increased morbidity. Therefore, a method of urinary diversion using the transverse colon conduit in an end-to-end ureterocolic anastomosis as described by Wallace was used. Several advantages with this method are identifiable easily and are described. The satisfactory results in the last 30 patients who underwent this procedure after pelvic irradiation are presented. The ureterocolic anastomosis with reflux is of particular importance since it allows retrograde conduitograms to be performed at later dates to evaluate the urothelium for possible recurrent disease.

Adenocarcinoma↗
PubMed1982

Transabdominal fine needle aspiration of retroperitoneal lymph nodes in staging of genitourinary tract cancer (correlation with lymphography and lymph node dissection findings).

Percutaneous fine needle aspiration of retroperitoneal pelvic and abdominal lymph nodes was done in 100 patients with clinically localized bladder, prostatic, testis and penile cancer. A diagnosis of metastases to regional lymph nodes was detected by this method in 20 patients. Fine needle aspiration revealed evidence of regional lymph node involvement in 6 of 40 patients (15 per cent) with negative findings on lymphography and computerized tomography scan. Lymph node aspiration was followed by lymph node dissection in 50 patients. The correlation between aspiration and dissection was 68 per cent. The accuracy of obtaining representative material from the lymph node aspiration was 83 per cent. Negative results of lymph node aspiration cannot be used in clinical management. However, positive aspiration results provide the clinician with valuable information obtainable otherwise only by laparotomy or lymph node dissection. Positive aspiration results may spare patients with prostatic and bladder cancer an unnecessary radical operation, and may indicate early chemotherapy or surgery in patients with testis and penile cancer.

Biopsy, Needle↗
PubMed1982

Treatment of testicular tumors arising in patients with previous inguinal and/or scrotal surgery.

Of 20 patients with testicular tumors that occurred after previous inguinal and/or scrotal surgery 6 with seminomas were treated with traditional radiation therapy that included the ipsilateral groin, while 14 with nonseminomatous tumors were treated with retroperitoneal lymph node dissection with or without chemotherapy. No patient suffered inguinal lymph node metastases. Based on the satisfactory results in these patients to date and the lack of subsequent detectable recurrence of tumor we do not advocate additional treatment to the superficial inguinal lymph nodes and scrotum.

Adolescent↗
PubMed1981

Estramustine phosphate with multiple cytotoxic agents in treatment of advanced prostatic cancer.

Twenty-five patients with histologically proved adenocarcinoma of the prostate were divided into two groups and submitted to combination therapy with estramustine (Estracyt), cyclophosphamide (Cytoxan), 5-fluorouracil, and Cisplatin. Group A consisted of 10 patients newly diagnosed Stage D disease with no prior treatment. Group B consisted of 15 Stage D patients who had become hormonally unresponsive. Group A patients demonstrated an initial 100 per cent response rate including 70 per cent partial objective responses and 30 per cent stabilizations. Group B patients had a 46 per cent response with 39 per cent complete and partial responses and 6 per cent as stabilized. Toxicity was tolerable judged by the NPCP criteria. Both groups of patients are still under study for up to two years to determine if this therapy is superior to other traditional therapies.

Adenocarcinoma↗