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At least 199 records · Page 11Linked to original sources
PubMed1995

[Coloanal anastomosis (Parks operation) in the treatment of acute radiation rectitis].

AIM: To assess immediate and late results of Parks operation in the treatment of severe radiation rectitis. PATIENTS AND METHOD: Retrospective review of clinical histories of 35 patients with uterine cervical cancer, 5 with endometrial cancer and one with vaginal cancer that received radiotherapy. Two years as a mean after radiotherapy, 14 women had rectal bleeding, 19 fistulae, 7 stenosis and 1 a rectal ulceration. All were initially treated with a discharge colostomy and after a mean interval of 1.6 years, a Parks operation was performed. RESULTS: One patient died after surgery (2.4%) due to peritonitis and sepsis. Early surgical complications were necrosis of descended colon in 2, intra-abdominal abscess in 1, splenic rupture in 1 and postoperative bleeding in 1. Colostomy was closed in 37 patients three months after surgery. During late follow up (ranging from 3 to 64 months) rectal continence has been assessed as good in 30 patients, fair in 5 and bad in 2. Three women required a new colostomy. CONCLUSION: Parks operation is a viable therapeutic alternative for severe radiation rectitis.

Adult↗
PubMedDate not supplied

PROGINS polymorphism of progesterone receptor is increased in female offspring with maternal exposure to diethylstilbestrol.

DES (Diethylstilbestrol) was used for the treatment of corpus luteum insufficiences in early pregnancy. Prenatal exposure to DES leads to an increased frequency of vaginal cancer in female offspring. DES causes persistent alterations of steroid hormone binding in the vaginal tissue. The frequency of a polymorphism (PROGINS) of human progesterone receptor (hPR) gene which is associated with an increased risk of sporadic ovarian cancer was tested in DES-exposed offspring with vaginal dysplasia. Genomic DNA was isolated from the serum of 15 US Caucasian DES-offspring. PROGINS analysis was performed using sequencing, gel-electrophoresis and SSCP-PCR. The results demonstrated that the frequency of PROGINS is increased in DES-offspring (DES: 6.7% homozygous, 26.7% heterozygous, normal US Caucasians: 3.3% homozygous, 15% heterozygous). Mutation screening of PROGINS is an important advantage for the clinical management of screening and can give additional information to prevent or find vaginal cancer in early stages in DES-offspring.

Carcinogens↗
PubMed1985

[Phase II study of 4'-O-tetrahydropyranyl-adriamycin (THP-ADM) in patients with gynecological cancer].

We conducted a joint phase II study in 76 patients with gynecological cancer (42 patients with ovarian cancer, 22 patients with cervical cancer, 10 patients with endometrial cancer and 2 patients with vaginal cancer). The response rate was 25.0% in the patients with ovarian cancer, 13.3% in those with cervical cancer, and 28.6% in those with endometrial cancer. The overall response rate was 23.1%. When the patients were classified according to dose schedules, the highest response rate was obtained in the group administered THP-ADM at a dose of 60 mg per body by single i.v. injection at 3-week intervals. Such side effects as myelosuppression and gastrointestinal disturbances were observed, but alopecia, a marked side-effect of ADM administration, was mild, and no cardiac toxicity was seen in any of the patients.

Adult↗
PubMed1997

Phase III randomized double-blind study to evaluate the efficacy of a polycarbophil-based vaginal moisturizer in women with breast cancer.

PURPOSE: Vaginal dryness and dyspareunia are significant estrogen-depletion symptoms that affect many breast cancer survivors. The present trial was developed to evaluate the nonhormonal vaginal lubricating preparation, Replens, for alleviating these symptoms. MATERIALS AND METHODS: A double-blind, crossover, randomized clinical trial was developed. Patients received 4 weeks of Replens (Columbia Research Laboratories, Rockville Centre, NY) followed by a 1-week washout period followed by 4 weeks of a placebo lubricating product, or vice versa. Weekly patient-completed diaries were used for measuring efficacies and toxicities of therapy. RESULTS: The 45 assessable patients provided well-balanced treatment groups. During the first 4 weeks, average vaginal dryness decreased by 62% and 64% in the placebo and Replens groups, respectively (P = .3). Average dyspareunia scores also improved by 41% and 60%, respectively (P = .05). Crossover analysis indicated that the bulk of the beneficial effects appeared within the first 2 weeks of the first treatment and remained constant thereafter. Both treatments were relatively well tolerated. CONCLUSION: Both Replens and the placebo appear to substantially ameliorate vaginal dryness and dyspareunia in breast cancer survivors.

Adult↗
PubMed1997

Prospective seroepidemiological study of role of human papillomavirus in non-cervical anogenital cancers.

OBJECTIVE: To evaluate the association between infection with the major oncogenic types of human papillomavirus and the risk of developing non-cervical anogenital cancers in a cohort followed up prospectively. DESIGN: Data from two large serum banks to which about 700,000 people had donated serum samples were followed up for a mean of 8 years. People who developed non-cervical anogenital cancers during follow up were identified by registry linkage with the nationwide cancer registries in Finland and Norway. Within this cohort a nested case-control study was conducted based on the serological diagnosis of infection with human papillomavirus types 16, 18, and 33. SUBJECTS: 81 cases and 240 controls matched for sex, age, and storage time of serum samples. MAIN OUTCOME MEASURES: Odds ratios of developing non-cervical anogenital cancers in presence of IgG antibodies to specific micro-organisms. RESULTS: Subjects seropositive for human papillomavirus type 16 had an increased risk of developing non-cervical anogenital cancers (odds ratio 3.1 (95% confidence interval 1.4 to 6.9)). Subjects seropositive for type 33 also had an increased risk (odds ratio 2.8 (1.0 to 8.3)) but not significantly after adjustment for infection with type 16. Seropositivity for human papillomavirus type 16 was associated with an increased risk of developing vulvar and vaginal cancers (odds ratio 4.5 (1.1 to 22)) and a strongly increased risk of developing preinvasive vulvar and vaginal lesions (odds ratio infinity (3.8 to infinity)). Seropositivity for human papillomavirus type 18 increased the risk of developing preinvasive lesions (odds ratio 12 (1.2 to 590)). High, but non-significant odds ratios for types 16 and 33 were seen for penile cancers. CONCLUSIONS: This study provides prospective seroepidemiological evidence that infection with human papillomavirus type 16 confers an increased risk of developing non-cervical genital cancers, particularly vulvar and vaginal cancers.

Adult↗
PubMed1991

High dose rate intracavitary brachytherapy for recurrent cervical cancer of the vaginal stump following hysterectomy.

Forty-eight patients with recurrent cervical cancer of the vaginal stump following hysterectomy for cervical cancer, were treated with high dose rate intracavitary brachytherapy with or without external irradiation. The intervals between primary surgery and vaginal recurrences varied widely from 3 months to 36 years. Patients were classified into two groups, either with or without palpable tumor of the vaginal stump. Tumor size was determined by bimanual rectovaginal examination at the time of recurrence. Survival rates were 8% for the group with palpable tumors and 80% for those without, respectively. The survival rate of patients who did not have palpable masses and were treated with brachytherapy alone was not improved by combination with external irradiation. The time interval from the primary hysterectomy to the recurrence did not influence survival. These results suggest that the only significant prognostic factor for recurrent cervical cancer after hysterectomy is tumor size. The relationship between recurrent cervical cancer of the vaginal stump and second primary vaginal cancer is also discussed.

Adult↗
PubMed1991

Percutaneous urinary diversion in gynecologic oncology.

During the 10-year period after 1979, percutaneous urinary diversion (PCUD) was performed on 35 patients whose mean age was 53.5 years (30-80 years). Twenty-one patients (60%) had Stage IIB-IV cervical cancer, 11 (31%) Stage IB-IIA cervical cancer, 2 (6%) Stage IB-II endometrial cancer, and 1 (3%) Stage IB vaginal cancer. All had radiological evidence of ureteric obstruction and 8 patients also had urinary tract fistulae. Serum creatinine levels were elevated in 24. Following diversion there was a significant fall in mean pretreatment creatinine levels from 482 mumol/liter (range, 70-1703 mumol/liter) to 131 mumol/liter (range, 60-290 mumol/liter; P less than 0.0001); those patients with normal creatinine levels prior to diversion also had a reduction in their levels. A significant fall in mean serum urea levels from 22.0 mmol/liter pre- to 11.9 mmol/liter post-PCUD (P less than 0.001) was also noted. Minor complications occurred and included hemorrhage, replacement/reinsertion, infection, and blockage. Median survival of the 35 patients after PCUD was 6 months (mean, 16.5 months). For the 11 with normal pretreatment renal function median survival was 16 months (mean, 41 months) compared to 2.5 months (mean, 5.1 months) for those with elevated pretreatment serum creatinine levels. Median survival with untreated malignancy was 7 months (mean, 19.6 months) and 6 months (mean, 12.3 months) in patients with previously treated cancer. PCUD is indicated in previously untreated patients with gynecologic cancer so that primary therapy can be instituted. The role of urinary diversion in patients with previously treated cancer must be individualized. Palliative diversion is appropriate in selected patients where additional therapy is expected to prolong life, where symptom control is needed, or to allow the patient to return home for a significant proportion of the remainder of life.

Adult↗
PubMed1995

Multiple primary malignancies in patients with gynecologic cancer.

A retrospective analysis was made of 1044 patients with gynecologic malignancies treated in our department over a 12-year period, in order to review the frequency and types of multiple primary neoplasms. Multiple primary neoplasms were detected in 45 (4.3%) cases, including 16 (2.1%) out of 733 cervical cancers, 14 (8.2%) out of 166 endometrial cancers, three (15%) out of 20 vaginal cancers and 12 (9.8%) out of 123 ovarian cancers. Fifteen cases were synchronous and the remaining 24 cases were heterochronous, with an average 4.9-year interval. The most frequent other site of neoplasm was the breast, particularly in patients with endometrial or ovarian cancer. We conclude that gynecologic malignancies are often associated with primary cancers elsewhere, especially in the breast, stomach, colon and thyroid. A patient presenting with a gynecologic malignancy should be thoroughly examined for a second cancer, as should patients being followed-up after treatment for genital tract cancer.

Journal Article↗
PubMed2000

Prevention and therapy for BRCA1/2 mutation carriers and women at high risk for breast and ovarian cancer.

The hereditary breast (BC) and ovarian (OC) cancer syndrome (HBOC) includes genetic alterations of various susceptibility genes such as TP53, ATM, PTEN or MSH2, MLH1, PMS1, PMS2, MSH3 and MSH6, BRCA1 and BRCA2. Germline mutations of the cancer-susceptibility genes BRCA1 and BRCA2 seem to be the major aetiology of the HBOC. Genetic counselling and identification of high-risk families may be essential (1) to provide the best method for genetic testing by explaining the sensitivity and specificity of the methods, (2) to offer the opportunity to participate in specific early cancer detection programmes (breast (self) palpation, ultrasound, mammography and magnetic resonance tomography for breast cancer; vaginal exploration and ultrasound for ovarian cancer), (3) to inform them about prophylactic medication (oral contraceptive pill (OCP), chemoprevention (tamoxifen, raloxifen, aromatase inhibitors)) or surgery (bilateral prophylactic mastectomy or oophorectomy) and (4) to provide individualized psychological support. To fulfil these broad demands, an inter-disciplinary counselling approach (gynaecological oncology, human genetics, molecular biology, psychotherapy) in the setting of a cancer genetic clinic seems the most appropriate. There, participation in predictive genetic testing or the use of preventive or therapeutic options may be discussed extensively with the subjects. In particular, preventive options are emotionally disturbing for the subjects, and in cases of previous cancer. BC chemoprevention for high-risk women does not seem to be as effective as expected. However, OCP reduces the risk for OC. For prophylactic surgery, various points have to be considered, including: (1) individual risk assessment and gain in life expectancy, (2) value of screening and early detection methods or medical prevention, (3) disease characteristics and prognosis, and (4) anxiety and quality of life. Decisions regarding these options have to be individualized and psychological support must be offered during the period of decision and follow-up.

Adult↗
PubMed2001

Preliminary experience with Mainz type II pouch in gynecologic oncology patients.

OBJECTIVE: To evaluate the Mainz low-pressure modification of ureterosigmoidostomy with extramural serous-lined ureterointestinal anastomosis as a method of urinary diversion in gynecologic patients undergoing anterior pelvic exenteration. MATERIALS & METHODS: Between December 1995 and September 1998, Mainz type II pouch was performed in 11 patients aged between 27-70 years (mean 58.5). Four were diagnosed with cervical cancer (2 stage IV A and 2 central recurrences following radical hysterectomy done elsewhere), two with stage III bilharzial bladder cancer, two with urethral cancer (one stage III and one recurrent following surgery done elsewhere), one with stage IV A endometrial cancer, one with stage IV A vaginal cancer complicating long standing incarcerated total procidentia and lastly one patient with refractory obstetric vesicovaginal fistula with almost total loss of the upper urethra, bladder neck and base. All patients were followed closely and particular complications related to the diversion were recorded as acid-base imbalance, renal impairment and incontinence. RESULTS: The pouch construction with anterior exenteration took an average of 242 min (150-330). There were two postoperative deaths due to pulmonary embolism and pneumonia both being related to the precarious condition of the patients and not to the diversionary procedure. The follow-up ranged between 25-60 months, with a mean of 43.5 months for the surviving patients. During that time period, four deaths occurred due to cancer recurrence. Otherwise, all patients remained continent during the day with one patient being incontinent at night. Two patients developed one attack of pyelonephritis and were treated successfully with antibiotics. No hyperchloremic acidosis and no hydronephrotic changes were seen in any patient and renal function remained normal. CONCLUSION: Mainz type II pouch with extramural serous-lined ureterointestinal anastomosis is a safe promising quick and easy method of urinary diversion for patients undergoing anterior pelvic exenteration and having an intact anal sphincter. Longer follow-up and a greater number of patients will be needed to compare it with other forms of urinary diversion.

Adult↗
PubMed1989

Serum squamous cell carcinoma antigen in gynecologic malignancies with special reference to cervical cancer.

Squamous cell carcinoma (SCC) antigen was measured by double-antibody radioimmunoassay in the sera of 113 patients with gynecologic malignancies and 30 controls. The mean serum SCC antigen level was 9.24 ng/ml in those with cervical squamous cell carcinoma, 2.15 ng/ml in those with other gynecologic malignancies, and 1.25 ng/ml in controls. With a cutoff value of 2.23 ng/ml (2 SD above the mean of the control group), the rate of SCC antigen elevation was 54% in cervical cancer (78), 14% in vulvar or vaginal cancer (7), 22% in ovarian cancer (18), and 10% in endometrial cancer (10). In cervical squamous cell carcinoma, the rates of elevated SCC antigen level increased with disease advancement in stages 0, I, II, III, and IV, by 13, 50, 53, 78, and 100%, respectively. In early-stage cervical squamous cell carcinoma, SCC antigen was not sensitive enough for screening. However, if elevated, serum SCC antigen levels decreased rapidly after successful surgical treatment. One case with a serum SCC antigen level above 65 multiples of the cutoff value had widespread cancer and postoperative recurrence. In the advanced case, the sensitivity was much higher. In the recurrent case, the positive rate was 73%. Serum SCC antigen level is useful in predicting the prognosis and monitoring the course of cervical squamous cell carcinoma, especially in the detection of a recurrence.

Antigens, Neoplasm↗