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At least 433 records · Page 24Linked to original sources
PubMed2005

Definitive radiotherapy in the management of isolated vaginal recurrences of endometrial cancer.

PURPOSE: The aim of our study was to assess prognostic factors and overall survival after salvage radiotherapy for patients who had endometrial carcinoma and who experienced an isolated vaginal recurrence. METHODS AND MATERIALS: We reviewed the records of 50 patients treated at our institution between 1967 and 2003 for an isolated vaginal recurrence of endometrial carcinoma. Initial treatment for endometrial carcinoma was definitive surgery in 49 patients and definitive radiotherapy in 1 patient. The median time from initial diagnosis of endometrial carcinoma to recurrence was 25 months (range, 4-179 months). Three patients (6%) received external-beam radiotherapy alone, 8 patients (16%) received brachytherapy only, and 39 patients (78%) received combined external-beam radiation therapy and brachytherapy. Median dose of radiation to the recurrence was 60 Gy (range, 16-85 Gy). Overall survival was calculated by the Kaplan-Meier method. Endpoints were measured from the date of diagnosis of the vaginal recurrence. Median follow-up of survivors after recurrence was 53 months (range, 8-159 months). RESULTS: The 5-year and 10-year disease-free and overall survivals were 68% and 55%, and 53% and 40%, respectively. On multivariate analysis, age (p = 0.0242), Grade 1 or 2 vs. Grade 3 tumor (p = 0.002), and size of recurrence (p < 0.001) were significant predictors of overall survival. All patients who had Grade 3 disease were dead by 3.6 years from the time of recurrence. Five patients experienced a Grade 3 or 4 complication. CONCLUSIONS: Patients treated with radiotherapy for an isolated vaginal recurrence can be cured in over 50% the cases. Radiotherapy is well tolerated, with a low risk of complications. Factors predictive of overall survival include tumor grade, patient age at recurrence, and tumor size.

Adult↗
PubMed1989

[Effect of vaginal antibiotics suppository on retroperitoneal-space infection after hysterectomy and lymphadenectomy for uterine cancer].

Effects of vaginal antibiotics suppository on the retroperitoneal-space infection were studied in 42 patients who had hysterectomy and lymphadenectomy with diagnosis of uterine cancer stage I or II. All patients received intravenous administration of 1 g LMOX (3 times/day) for 7 days after operation. One group of patients (21 cases) received 0.5 g of ABPC vaginal suppository (twice/day) for 10 days immediately after operation. Another group of 21 patients did not received vaginal suppository. The LMOX concentrations in the exudate decreased rapidly from the 3rd day to the 7th day. The frequencies of bacterial appearance in the retroperitoneal-space in the vaginal suppository group were 33% on 5th day, 33% on 7th day and 20% on 9th day, while those in the control group were 100%, 100% and 76%, respectively. It was concluded that the administration of vaginal antibiotics suppository was easy to handle and effective for preventing the retroperitoneal-space infection after hysterectomy and lymphadenectomy.

Ampicillin↗
PubMed1990

Detection of mutagenicity in cervico-vaginal secretions--a plausible risk factor for cervical cancer.

The cervico-vaginal secretions from 51 women with various grades of dysplastic lesions of uterine cervix were assessed for mutagenic potential by Ames test using histidine deficient mutant strain of Salmonella typhimurium TA-98: with S-9 mix. Twenty three per cent of samples from women with cervical dysplasia were found significantly positive (P less than 0.001) for mutagenic activity compared to 3% positive from control. The frequency of mutagenic secretions detected were almost uniform, irrespective of the severity of cervical lesions. None of cervico-vaginal secretions, positive for mutagenicity could revert the tester strain when tested in absence of S-9 mix (liver microsomal enzymes). This indicates that mutagens in cervico-vaginal secretions are effective only when activated enzymatically.

Animals↗
PubMed2004

Animal models and studies of in utero endocrine disruptor effects.

The rate of organ and system development in mammals, including humans, is most rapid during the prenatal period. Perturbations of the endocrine system during this period can have profound effects on later anatomy, physiology, behavior, and the onset of disease. Endocrine-disrupting compounds can cause perturbations during fetal development by mimicking or blocking natural hormones. In experimental studies, compounds that mimic estrogens and those that block androgen action have been shown to have a number of long-term effects. Among these effects are the acceleration of puberty onset, increased incidence of adult cancers such as vaginal and prostate cancers, and alterations in sexually dimorphic anatomy, physiology, and behavior. Laboratory animal models continue to play a crucial role in identifying endocrine disruptors, determining their mode of action, and demonstrating their consequences.

Animals↗
PubMed2006

Human papillomavirus quadrivalent (types 6, 11, 16, 18) recombinant vaccine (Gardasil).

Human papillomavirus (HPV) quadrivalent recombinant vaccine is a mixture of virus-like particles derived from the L1 capsid proteins of HPV types 6, 11, 16 and 18. It is administered intramuscularly in a three-dose regimen, with the initial injection followed by subsequent doses at months 2 and 6. The vaccine is indicated for use in the prevention of cervical cancer, vulvar and vaginal precancer and cancers, precancerous lesions and genital warts associated with HPV types 6, 11, 16 or 18 infection in adolescents and young women. The quadrivalent vaccine has demonstrated good immunogenicity in young women (16-26 years) and male and female adolescents (aged 9-15 years), inducing high and persistent anti-HPV antibody titres. In a randomised phase III trial designed to bridge efficacy in young women to adolescents (using immunogenicity as a surrogate), the quadrivalent HPV vaccine in adolescents was at least as immunogenic as that in young women. In randomised, double-blind, placebo-controlled trials in >20 000 young women (aged 16-26 years), the vaccine was highly effective in preventing cervical dysplasia of any grade and external genital lesions related to HPV types 6, 11, 16 and 18 infection. These women were followed up for an average of 2 years.black triangle The vaccine was well tolerated, with injection-site reactions and fever being the most common vaccine-related adverse events.

Female↗
PubMed1985

The use of a tumor antigen TA-4 for the management of squamous cell carcinoma.

A radioimmunoassay for a tumor antigen TA-4 of squamous cell carcinoma has been used for the management of cervical cancer. The present study shows the clinical value of the TA-4 assay for squamous cell carcinoma of various origins. Pretreatment serum TA-4 levels were detectable in 44.4% of cervical cancer, 47.1% of vaginal and vulvar cancer, 33.3% of lung cancer, 42.9% of esophageal cancer, and 10% of cancer of other origins. In 313 control cases, including other histologic types of malignancies or benign diseases, one case showed a positive TA-4 level. Serial determinations of serum TA-4 levels were performed in patients with squamous cell carcinoma, which revealed that changes in TA-4 levels were rapid and were helpful for monitoring the disease progress and for detecting the recurrent disease. These results indicate that the TA-4 assay would be a useful aid for the management of squamous cell carcinoma of various origins.

Antigens, Neoplasm↗
PubMed1987

[Functional disorders of the lower urinary tract following radical abdominal and vaginal surgery of cervix cancer].

To establish the prevalence and extent of lower urinary tract dysfunction after radical surgery for cervical cancer, we evaluated 121 patients who underwent surgery between 1978 and 1984. 91 women underwent radical abdominal hysterectomy for disease in stage Ib or IIb; 30 patients underwent radical vaginal hysterectomy for stage Ib disease. Evaluation, at 12-72 months postoperatively, included pelvic examination, urinary history (explored via a specially designed questionnaire), measurement of residual urine, urine culture, and urodynamic studies. All patients underwent urethrocystoscopy and intravenous urography. Results showed 36 patients completely free of complaints, namely, 17 (18.7%) after radical abdominal hysterectomy and 19 (64%) after the vaginal produce. 85 patients (70%) had complaints, most commonly difficult spontaneous micturition (81.4% after abdominal, 17% after vaginal surgery). Other pathologic conditions were identified as follows: stress incontinence in 52.8% of patients after abdominal and 24% after vaginal surgery; impaired bladder sensation in 48.4% after the abdominal procedure but in only 13% after the vaginal; residual urine volume exceeding 10% of maximum bladder capacity in 13.2% after abdominal surgery (range: 40-220 ml) and 24.2% after vaginal surgery (range: 30-200 ml); significant bacteriuria in 21 patients (23%) after abdominal hysterectomy and 3 patients (9%) after vaginal. Urodynamic studies showed that, after abdominal surgery, bladder compliance was normal in 41.8% of patients, high in 39.6%, and low in 18.7%. After vaginal surgery, bladder compliance was normal in 66% of patients and abnormal in 34%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

The vaginal radical operation of cervical cancer.

Choosing the surgical technique for the cervix carcinoma--vaginal or abdominal--it is particularly necessary to take into account the lymphatic spread of the cervix. As it is not possible to realize a lymphadenectomy in a vaginal procedure, it has to be found a preoperative diagnostic method which enables very surely the exclusion of lymph node involvement. In summary of the facts stated up to now, one can conclude as follows: 1. The FIGO-classification is too subjective. 2. There is a significant correlation between tumor volume and lymph node involvement. 3. The tumor markers--as e.g. PCNA, p53, c-neu, EGF, beta 1 Integrin etc.--show no correlation with the lymph node involvement. 4. Only MRI allows an exact preoperative measurement of the tumor volume. 5. On account of the above mentioned results, it seems to be possible to extend the indication for the vaginal radical surgery on cases with a small tumor volume.

Biomarkers, Tumor↗
PubMed1985

Vaginal recurrence after cystectomy for bladder cancer.

The records of 14 patients with vaginal recurrence following cystectomy were reviewed in an attempt to find factors responsible for the local failure. Comparison was made with female patients who underwent cystectomy for bladder cancer during the same period but who did not have vaginal recurrence. Patients with previous surgery and radiation to the pelvic organs appear to be at risk for local recurrence, probably because of the difficulties associated with surgical removal of the bladder. Patients with tumors other than transitional cell carcinoma, especially those located at the bladder neck and urethra, also appear to be at high risk. Proper surgical technique with en bloc cystourethrectomy, including excision of the anterior vaginal wall, is of paramount importance to avoid local recurrence.

Aged↗
PubMed2000

Combined laparoscopic and vaginal radical surgery in cervical cancer.

OBJECTIVE: The purpose of our study was to review our experience with laparoscopic staging and vaginal radical surgery in the treatment of early stage cervical cancer. STUDY DESIGN: We reviewed the charts of 102 patients who had a laparoscopic pelvic lymphadenectomy followed by vaginal radical hysterectomy (VRH) or vaginal radical trachelectomy (VRT). RESULTS: Patients' age ranged from 25 to 68 years (median: 36). Squamous and adenocarcinoma histology occurred in 68 and 32%, respectively. Stage Ib1 occurred in 77% of cases and the rest were stage Ia1 (1%), 1a2 (16%), and IIa (6%). Patients were divided into three groups: VRH (57), VRT (34), and node only (NO) (11), when positive nodes were identified on frozen section. Median operative time for VRH and VRT were 270 and 260 min compared to 200 min in the NO group (half also had bilateral paraaortic node dissection, which lengthened the OR time). Hospital stay was shorter in the NO group (2 days). For each group (VRH, VRT, and NO) the median pelvic node count was 27, 26, and 23 and the median paraaortic node count was 3, 4, and 9. Two VRH were converted to an abdominal procedure because of technical difficulties and one VRT was converted to a VRH because of positive endocervical margins. Intraoperative complications related to laparoscopy included two iliac and one epigastric vessel injuries. Complications related to the radical surgeries included three cystostomies, managed vaginally, and a laparotomy for parametrial bleeding after VRT. Postoperative complications occurred in 6% of patients and only one was considered major (an abscess which required surgical drainage). Overall, there were only four recurrences in the vaginal surgery groups and one in the NO group. There were no ureteral or intestinal injuries and there have been no trocar site recurrences. CONCLUSION: Our data show that approaching cervical cancer with a combined laparoscopic and vaginal surgery is feasible. The overall morbidity and complication rate are low and the lymph node count is satisfactory. Staging the nodes laparoscopically first to identify positive nodes is advantageous, particularly since we favor the use of chemoradiation therapy in those cases. The laparoscopic node staging thus avoids an unnecessary laparotomy in patients with positive nodes, reduces morbidity, and allows for early radiation therapy.

Adenocarcinoma↗