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At least 847 records · Page 47Linked to original sources
PubMed1990

[Combined interventions in non-organic neoplasms of the small pelvis].

Experience with 62 combined operations on patients with nonorganic new growths of the true pelvis is discussed. They accounted for 33.3% of 227 radical interventions undertaken for this disease. The ages of the patients ranged from 4 months to 64 years. Ten patients were admitted after exploratory laparotomies. Benign new growths were diagnosed in 14 and malignant new growths in 48 patients. Different variants of operative approaches were used. Most frequently the tumor was resected together with bones, iliac vessels, genitalia, and urinary bladder. Various complications were noted in 39 patients who were operated on. Hemorrhage was the most frequent and menacing complication--in 26 patients. Two patients died. Recurrences were found in 8 of a group of 60 patients discharge from the clinic. After combined operations for malignant nonorganic tumors of the true pelvis 3-year survival was 36.0%, 5-year survival was 29.4%.

Adolescent↗
PubMed1990

[A case of giant prostatic cystadenoma].

An 80-year-old man was admitted to our hospital with the chief complaint of urinary retention. On physical examination, a large tumor was recognized in pelvic cavity. Serum levels of prostatic acid phosphatase and gamma-seminoprotein were elevated. Anterior pelvic exenteration was performed because the tumor was huge and malignancy could not be ruled out preoperatively. The tumor weight was 660 g (11 x 8 x 7 cm) and had a multicystic structure macroscopically. Immunohistochemical study by the prostatic specific antigen stain showed positive staining in the epithelial cells of the tumor, which suggest that the tumor was of prostatic origin.

Aged↗
PubMed1990

Kock to urethra: continent functional bladder replacement.

Since 1950 when Bricker first described the construction of the ileal conduit, this procedure has become a standard method of urinary diversion after pelvic exenteration. Recently, increasing interest in continent diversions has resulted in the development of several new procedures, using both small bowel and large bowel to produce and internal urinary reservoir. Such reservoirs still maintain a urinary stoma which requires periodic catheterization for emptying. With the development of the Kock low-pressure urinary reservoir, it has now become possible to re-establish the continuity of the urinary system by anastomosing this internal reservoir to the posterior urethra. This procedure utilizes the distal urethral sphincter as a continence mechanism and allows functional bladder emptying without a stoma. An antireflex valve is constructed to protect the kidneys. The authors report their experience with 20 such diversions, describing the operative technique, detailing the perioperative complications and providing urodynamic evidence of restored bladder function.

Aged↗
PubMed1990

The surgical management of recurrent squamous cell carcinoma of the vulva.

Thirty-four patients with recurrent/persistent squamous cell carcinoma of the vulva were treated at the University of Michigan Medical Center from 1975-1988. At follow-up, 19 patients (56%) were free of disease and 15 were dead of disease. Three patients developed a "bridge" recurrence, one patient each with original stages I, II, and IV. Two of these patients were free of disease and one patient died of disease. Ten patients had metastatic disease to the groin lymph nodes at the time of recurrence, and all of these patients are dead of disease. Therapy for the recurrence consisted of five radical vulvectomies (80% survival), four pelvic exenterations (25% survival), and 25 wide radical excisions (56% survival). The lymph node status was highly significant in predicting outcome, with zero of ten patients remaining free of disease when the lymph nodes were involved and 19 of 24 free of disease when the lymph nodes were uninvolved (P less than .0001). Factors that did not influence survival included the institution where the initial surgery was performed and the interval from initial therapy to recurrence. Twenty patients received their initial therapy at the University of Michigan and 12 (60%) were free of disease. Fourteen patients were referred from outside institutions for their recurrence and seven (50%) were free of disease. Nineteen patients had a recurrence within 2 years and nine were free of disease, ten patients recurred between 2-10 years of whom seven were free of disease, and five patients recurred after 10 years with three free of disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Squamous Cell↗
PubMed1989

[Sarcoma of the uterus. A clinical study apropos of 50 surgically treated cases at the Gustave Roussy Institute. Review of the literature].

From 1970 to 1987 fifty patients with uterine sarcoma who have been operated at the G. Roussy Institute (IGR) were studied. The histological material was reviewed according to the W.H.O. classification and the Hendrickson and Kempson's criteria. Staging was done on surgical and histological findings according to the pTNM classification of the UICC for endometrial carcinoma. There were 22 cases of heterologous malignant mixed müllerian tumor (MMT), 5 cases of homologous MMT, 20 cases of leiomyosarcoma (LS), 1 high grade stromal sarcoma, 1 low grade stromal sarcoma (stromal myosis (SM], 1 adenosarcoma. There were 22 cases of stage T1 T2, 23 cases of stage T3 T4 and 5 TX (first surgery outside IGR). Total hysterectomy with bilateral salpingo-oophorectomy was performed in 86% of the cases. Radiation therapy was performed in 26 cases mostly external pelvic irradiation associated with endobrachytherapy. "Cyvadic" combination chemotherapy was used in 16 cases associated with platinum in few cases. There were 2 postoperative deaths, 11 cases of progression and 37 cases of complete remission (CR). Of the 37 cases of CR, 10 patients are alive with NED 6 months to 10 years after diagnosis in 2 cases of MMT. 27 patients presented recurrence or metastasis. Of the 22 patients with pelvi-abdominal recurrence, 10 had debulking surgery (one total pelvic exenteration (PE), three posterior PE). Among them five are alive 14 to 78 months later (3 LS, 1 AS, 1 SM). Thirty percent of the patients developed lung metastasis. The overall five-year survival was 42 +/- 16% (28 patients) (Kaplan-Meier's method), similar to literature data.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Current role of pre-scalene biopsy in the pretherapeutic evaluation of invasive cancer of the uterine cervix].

Despite coded staging of localization studies in cancer of the uterine cervix, numerous authors have attempted to improve knowledge concerning certain prognostic factors, of which the most important in lymph node status. It is with this in view that pre-scalene biopsies are performed. Their adjunction to pretreatment investigations appears to be determining, especially in advanced-stage forms when aggressive surgical (pelvic exenteration), radiation (lomboaortic irradiation) or even chemotherapeutic treatments are being considered. Because of the wide variation in the results in the literature and the lack of precision of the indications of this low-morbidity surgical procedure, the authors decided to define the place of this supraclavicular lymph node investigation for staging. While it need not be systematic in the early stages of the disease, this does not seem to be the case in advanced stages and recurrences which call for a more moderate attitude.

Biopsy↗
PubMed1985

Primary sarcoma of the adult vagina: a clinicopathologic study.

Combination chemotherapy has dramatically improved the results of treatment for embryonal rhabdomyosarcoma of the vagina in children, but little attention has been directed toward vaginal sarcomas in adults. This report of 17 cases of primary sarcoma of the adult vagina includes ten leiomyosarcomas, four mixed mesodermal tumors, one undifferentiated sarcoma, one stromal sarcoma, and one neurofibrosarcoma. The leiomyosarcomas, mixed mesodermal tumors, and the stromal sarcoma were morphologically similar to their uterine counterparts. Thirty-five percent of the patients had received pelvic irradiation for carcinoma of the cervix. Three of four patients treated by pelvic exenteration are alive and disease free after 84 to 161 months of observation. All 13 patients who received other forms of primary therapy died of recurrence. The pelvis was the first site of recurrence in all treatment failures and the only site of failure in 50%.

Adenocarcinoma↗
PubMed1988

[Progress in the treatment of cervical cancer].

The cure rate of cervical cancer is undoubtedly improved by early detection accomplished by mass-screening programs. Improvements in surgical technique have also reduced the incidence of complications. Conization or laser vaporization for stage 0 and extended hysterectomy for stage Ia are demonstrated to be appropriate treatment modalities. Extended surgery, such as total pelvic exenteration, is applied for advanced cancer. For radiation treatment, fast-neutron irradiation, intraoperative irradiation and interstitial irradiation have been tested. Hyperthermia combined with irradiation is one of the most attractive methods, which deserves further investigation. Irradiation of the para-aortic lymph nodes has been started by many institutions. Great progress has been achieved in chemotherapy for cervical cancer. Multi-drug combination chemotherapy including cis-platinum has yielded promising results, and intra-arterial infusion and long-term maintenance chemotherapy have been tried with the expectation of favorable outcome. It is concluded that individualized multi-disciplinary treatment will be the best approach for cervical cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

[Repeated and combined operations in tumors of the retroperitoneal space].

Based on an experience with the treatment of 76 patients with tumors of the retroperitoneal space the authors show the expediency of operations of a "region resection" type with the intraoperative control of hemostasis. Such operations were performed in 18 patients with left-side tumors and in 7 patients with the right-side localization of tumors. The choice of the regional resection is considered by the authors to elevate the resectability in patients with tumors of the retroperitoneal space.

Adolescent↗
PubMed1986

[A case of leiomyosarcoma of the prostate].

A 50-year-old man with the symptom of anal pain was treated by pelvic exenteration, ileal conduit diversion and artificial anus. The pathologic diagnosis was leiomyosarcoma of the prostate. At 5 months post-operatively, the patient had no evidence of metastasis or recurrence.

Humans↗
PubMed1987

Clinical patterns of tumor recurrence after radical hysterectomy in stage IB cervical carcinoma.

We reviewed the cases of 31 patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical carcinoma who developed recurrent disease after radical hysterectomy and pelvic lymphadenectomy between 1961 and 1982. The overall incidence of recurrence was 11.3%. Recurrence was significantly more common in patients with adenocarcinoma or adenosquamous carcinoma (17.4%) than in those with pure squamous tumors (9.2%). The median time from operation to recurrence was eight months. The median survival of patients dying of disease was 18 months. Sites of recurrence were categorized as central pelvic in 35% of cases, pelvic sidewall in 39%, and distant in 26%. Patients treated with postoperative pelvic radiotherapy for positive pelvic nodes or surgical margin involvement were more likely to develop distant recurrence. Various therapeutic modalities were used to treat recurrent disease. Twenty-two of 23 patients with central pelvic or sidewall recurrence failed radiation therapy. None of four patients with central recurrence treated by pelvic exenteration survived. No patient treated with chemotherapy survived. Overall survival for patients with recurrence was 3.2%. The dismal prognosis for this group of patients warrants evaluation of alternative treatment modalities.

Adenocarcinoma↗
PubMed1986

[Malignant peritoneal mesothelioma of the prostate: a case report].

A case of malignant peritoneal mesothelioma of prostate in a 52-year-old male is reported. He was admitted to the hospital with the complaint of perineal pain. The prostate was enlarged markedly, elastic soft and severely tender. CT scan and some examinations suggested the possibility of prostatic malignancy. The histological findings of the needle biopsy specimen revealed peritoneal mesothelioma. Complete pelvic exenteration was performed, because of direct invasions to the urinary bladder and the rectal anterior wall. The final pathological diagnosis revealed malignant fibrous peritoneal mesothelioma with solitary type of the rectovesical recess. At three months after the operation, the patient died of local resurrence and multiple metastasis to liver and lung. Only three cases of peritoneal mesothelioma, with solitary type, of rectovesical recess or retrovesical space have so far been reported in Japan.

Humans↗