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A N Van Geel

Publications and source records attributed to A N Van Geel.

7 recordsLinked to original sources
PubMed1999

Isolated limb perfusion with tumour necrosis factor-alpha and melphalan for unresectable bone sarcomas of the lower extremity.

AIMS: Isolated limb perfusion (ILP) with recombinant tumour necrosis factor-alpha (rTNF-alpha) and melphalan has recently been reported to induce major tumour responses and permit limb salvage in over 80% of patients with unresectable soft-tissue sarcomas of the extremities. We investigated whether TNF-based ILP could allow limb-sparing surgery in patients with primary, recurrent or metastatic bone sarcoma to the lower extremity who met the criteria for an amputation and had failed or refused chemotherapy. METHODS: From August 1992 to December 1997, we employed ILP with rTNF-alpha and melphalan in 13 patients with unresectable bone sarcoma of the lower extremity, all of whom were candidates for amputation. The aim was to reduce tumour size and allow the performance of a limb-sparing surgery (LSS). RESULTS: Following ILP, none of the patients had severe local toxicity and only one patient experienced significant systemic side-effects. LSS was subsequently performed in nine of the 13 patients. LSS was feasible in an additional three patients but was not performed because of the emergence of diffused metastatic disease. CONCLUSIONS: ILP with rTNF-alpha and melphalan can allow limb salvage in patients wih locally advanced bone sarcomas who had failed standard treatment options. Its potential role in the treatment of unresectable bone sarcomas of the extremities merits further evaluation.

Adolescent↗
PubMed1995

[Consensus soft tissue tumors. Dutch Workgroup Soft-Tissue Tumors].

Soft-tissue sarcomas constitute a rare group of malignant tumours with histopathological features of connective, muscular, fatty or peripheral nervous tissue. The prognosis at manifestation depends on only two factors: the spread, both local and remote, and the biological behaviour of the tumour. The latter factor cannot be influenced but the former can: by inexpert manipulation. Consequently, tumours suspected of being soft-tissue sarcomas require multidisciplinary management from the beginning, with the team members familiar with each other's diagnostic and therapeutic skills. Imaging diagnostic methods should precede invasive methods for collection of material for pathological examination. The number of mitotic figures observed at microscopical examination of the tissue is an important prognostic feature. Surgical resection is the treatment of first choice. Radiotherapy is indicated in grade 3 tumours, after recurrence surgery, and when radical resection would involve too much mutilation. Chemotherapy is only given in the context of clinical trials. Surgical treatment of lung metastases may be indicated in selected patients. Regional isolated perfusion with tumour necrosis factor may be an alternative for limb amputation.

Biopsy↗
PubMed1991

The pedicled omentoplasty: technical aspects in reconstructive and protective surgery.

A pedicled omentoplasty is a simple and safe method to reconstruct soft-tissue defects. A pedicled omentoplasty can also be used as an adjuvant surgical procedure in preventing anastomotic leakage and radiation damage. The way a pedicled omentoplasty should be performed is described in detail with special attention to transposing techniques.

Humans↗
PubMed1991

Carcinoma of the duodenum after trauma, radiotherapy and chemotherapy.

The case history is reported of a patient with a carcinoma of the duodenum 30 years after blunt abdominal trauma at the site of the 'scar' in the duodenum. Thirteen years after the trauma the patient was treated with chemotherapy and abdominal irradiation for a relapse of Hodgkin's disease. At follow-up, 25 months after the operation, he had no local recurrence of Hodgkin's disease or duodenal cancer. The possible relation between the cancer and the abdominal trauma, chemotherapy and abdominal irradiation is discussed.

Abdominal Injuries↗
PubMedDate not supplied

Hyperthermic isolated limb perfusion for the treatment of soft tissue sarcomas.

Hyperthermic isolated limb perfusion (HILP) with various chemotherapeutic agents has been used for the local treatment of high-grade soft tissue sarcomas (STS) of the extremities, but in most cases, with a disappointing result. Most such regimens certainly should not be considered superior to surgery plus radiotherapy. Although the majority of extremity STS can be resected locally, some are very large and are in close proximity to bone, nerve or blood vessels. In these cases, amputation is the only means of resecting the tumour. A new combination of drugs used in the set-up of HILP with tumour necrosis factor-alpha and melphalan has emerged as a very promising option for the limb-saving management of locally advanced STS. In recent studies, complete response rates of approximately 30% and partial remission rates of 50% have been achieved, while the overall limb-salvage rate is more than 80%.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Normothermic isolation perfusion with melphalan for advanced melanoma of the limbs.

Eighteen patients with advanced melanoma of the limbs underwent a single isolation perfusion with melphalan under normothermic conditions, i.e. tissue temperatures between 37.0 and 38.0 degrees C. There were no major complications. In 7 patients complete remission was achieved and in 8 the remission was partial, i.e. tumor reduction greater than 50%. No obvious response was seen in the remaining 3 patients. At the time of analysis 4 patients were still in complete remission, 56, 55, 19 and 8 months after perfusion, respectively. One patient died from distant spread, 17 months after perfusion, but without exhibiting new tumor growth in the perfused area. In 2 patients local control was transient with locally recurrent disease 28 and 10 months after perfusion, respectively. In patients with partial remission the duration of remission could not be determined because of supplementary treatment or death. Our results seem to be comparable to those obtained by so-called mild hyperthermic perfusions.

Chemotherapy, Cancer, Regional Perfusion↗