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Biomedical subjects

B Cedermark

Publications and source records attributed to B Cedermark.

65 records · Page 4Linked to original sources
PubMed1984

Breast-conserving treatment for breast cancer in Stockholm, Sweden, 1977 to 1981.

Since 1977 patients living in Stockholm with Stage I breast cancer fulfilling specific criteria are offered breast-conserving treatment. The treatment includes a partial mastectomy and a low-axillary dissection followed by radiotherapy, 5000 rad, to the remaining breast. Between 1977 and 1981, 262 patients underwent the breast conserving therapy. One hundred eighty-six patients had pathologic Stage I tumors. Radiotherapy was given to 158 of those patients. During the follow-up time (6 months to 5 years), 4 of 186 patients had recurrence to the breast. Two of those had not received radiotherapy. Recurrent tumor in regional lymph nodes occurred in 4/186, and distant metastases in 10/186 patients. Six patients have died of their disease. The cosmetic results were favorable overall, but often impaired when surgical complications occurred. A comparison between these results and those obtained in similar patients treated with modified radical mastectomy with a low-axillar dissection followed by radiotherapy to the remaining breast seems to be an alternative treatment to modified radical mastectomy. Longer follow-up time is needed before final conclusions can be drawn.

Adult↗
PubMed1984

Treatment of patients with disseminated colorectal cancer with recombinant human alpha 2-interferon. Studies on the immune system.

The influence of recombinant human alpha 2-interferon (alpha 2-IFN) therapy on various aspects of the immune system was studied in 18 patients with disseminated colorectal cancer. The IFN was given as continuous (20 X 10(6) units/m2 three times weekly) or intermittent (50 X 10(6) units/m2 daily for 5 consecutive days every 4 weeks) treatment. Natural killer (NK) cell activity increased during continuous treatment and in the patients receiving repeated cycles of IFN, all cycles seemed to be associated with an elevation of NK activity. Prior to treatment, addition of IFN to the assay in vitro induced an enhancement of NK activity, whereas during treatment, IFN in vitro did not cause any further enhancement of NK activity. The proportions of total T cells, suppressor T cells and helper T cells, as measured by Leu 1, Leu 2a and Leu 3a monoclonal antibodies, were not altered to any major extent during treatment. This was found to be the case also for the number of cells detected by monoclonal antibodies against NK cells (Leu 7). The phagocytic activity of granulocytes was not altered during IFN therapy, whereas the capacity of these cells to reduce nitroblue tetrazolium (NBT) increased after the first injection of IFN. The in vivo influence of high doses of highly purified recombinant alpha 2-IFN on NK cells and granulocytes seems to be similar to that of partially purified natural IFN-alpha.

Adenocarcinoma↗
PubMed1984

The significance of DNA distribution pattern in rectal carcinoma. A preliminary study.

The DNA distribution pattern was determined retrospectively in 25 rectal carcinomas and the possible correlation to clinical outcome evaluated. The DNA content in individual cells was measured according to a cytophotometric method based on light transmission measurement of Feulgen-stained nuclei. Tumor cells with DNA content exceeding an upper limit, i.e., the 90 percentile of the control cells, were considered to be nondiploid (aneuploid). Virtually all long-term survivors had less than 50 per cent of the tumor cells exceeding the upper diploid level, whereas those developing only a local recurrence had 50 to 70 per cent. Patients with disseminated disease and short survival time had all of their tumor cells exceeding the upper diploid level. There was a highly significant correlation between Dukes' stage and aneuploidy and probably a significant correlation between histologic grading and aneuploidy. The clinical significance of these results lies in the fact that DNA can be measured in biopsy specimens. It might thus be possible to "tailor" the operation according to the future clinical course to be expected. It could be hypothetically argued that patients with a DNA profile heralding disseminated disease and short life expectancy should have surgery that preserves quality of life, whereas those tending to develop a local recurrence should have more aggressive surgery. It may also be possible to define groups of patients thought to prosper from a more intense postoperative surveillance. The scientific basis for these suggestions is still lacking, and further studies on a prospective basis are currently in progress.

Adenocarcinoma↗
PubMed1984

High dose rDNA human alpha 2 interferon therapy in patients with advanced colorectal adenocarcinoma: a phase II study.

Eighteen patients with advanced and inoperable colorectal adenocarcinomas were treated with high doses of alpha 2 Interferon (Schering-Plough Corporation). The patients were randomized to receive either subcutaneous injections of 20 X 10(6) I.U./m2 three times weekly for 3 months, or pulsed treatments of 50 X 10(6) I.U./m2 daily, given intravenously, for 5 consecutive days every 4 weeks. No objective tumour regression was seen in any patient. The side effects were considerable.

Adenocarcinoma↗
PubMed1984

Parathyroid carcinoma--problems in diagnosis and treatment.

Four patients with parathyroid carcinoma operated on at the Karolinska Hospital were reviewed. In three patients the parathyroid carcinoma was suspected at the primary operation and successfully treated with excision of the tumour and ipsilateral hemithyroidectomy. In one patient the diagnosis was made only after local recurrence of the tumour and the appearance of lung metastasis. Although removal of local recurrence and distant metastasis was not curative, the patient improved for a long period of time. When surgical resection did not successfully control the hypercalcemia, Mithramycin, 12.5 micrograms/kg intravenous daily was given for five days. With two days interruption the treatment was repeated. The hypercalcemia could in this manner be controlled for almost one and a half years. It is concluded that parathyroid carcinoma is a relatively rare endocrine tumour which may be cured by adequate initial operation. When surgery is not feasible to control hypercalcemia, Mithramycin seems to be the drug of choice even for long-term therapy.

Adult↗
PubMedDate not supplied

Pancreatic tumors in multiple endocrine neoplasia type 1: clinical presentation and surgical treatment.

Among 33 patients with endocrine pancreatic tumors due to multiple endocrine neoplasia type 1 (MEN-1), 19 (58%) patients had hypergastrinemia, 7 (21%) patients had hyperinsulinism, and 7 (21%) patients had clinically non-functioning lesions. At least one gross tumor was found in all patients undergoing pancreatic surgery, including those with negative localization studies prior to operation. The patients also had additional macroscopic tumors as well as numerous microadenomas, and the lesions frequently were positive for immunostaining with multiple hormones, mainly pancreatic polypeptide, insulin, glucagon, and somatostatin. Duodenal endocrine lesions were found in 4 of 5 investigated patients and stained with gastrin and somatostatin antibodies. Distal, mainly subtotal pancreatic resection, was performed in 18 patients, eventually combined with caput tumor enucleation or duodenotomy, while a few patients underwent only tumor enucleation or a Whipple procedure. The long-term outcome of operation was most favorable in patients with hyperinsulinism; only 1 patient had clinical recurrence. Patients with hypergastrinemia experienced only transitory lowering of serum gastrin values after pancreatic surgery and 47% of them had or developed metastases. Such tumor spread was seen in 57% of the patients with non-functioning lesions. Nine patients died from progressive tumor disease during follow-up. Consistent with previous studies, we found that surgery is indicated in MEN-1 patients with hyperinsulinism even if a lesion is not visualized by radiology. In addition, these indications should be extended to also include patients with only biochemical markers of disease, including elevations of gastrin, as these indicate the presence of gross tumors.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Clinical characteristics, treatment and survival in patients with pancreatic tumors causing hormonal syndromes.

Eighty-five patients with endocrine pancreatic tumors associated with clinical syndromes of hormone excess were retrospectively analyzed regarding symptomatology, means of diagnosis, and results of surgical and medical treatment during follow-up of 3-18 years (median 8 years). The combination of angiography and computed tomography was most successful in pre-operative localization of both primary tumors and metastases. Surgery provided long term cure in 39 of 44 patients with benign islet cell lesions, the majority having insulinomas. Forty-one patients had malignant tumors, which at the time of diagnosis or operation were associated with liver and/or regional lymph gland metastases in 56% and 24%, respectively. Sixteen patients with metastatic disease and/or very large tumors were considered inoperable, 5 patients underwent palliative resection of their malignant tumors, while grossly radical tumor removal was accomplished in 20 patients. Long-term cure was achieved in 5 patients by excision of primary tumors and localized liver or lymph gland metastases. Half of the patients, particularly those with insulinoma, gastrinoma, or vipoma, showed response to streptozotocin, in combination with other cytostatics, for a median of 24 months or a response to interferon for a median of 10 months. The overall 5-year and 10-year survival among the patients with malignant islet cells tumors was 54% and 28%, respectively. Absence of liver metastases at time of operation/diagnosis, smaller size of the primary tumor, grossly radical tumor resection as well as response to medical therapy predicted the more favorable survival.

Adenoma, Islet Cell↗
PubMedDate not supplied

Neuropeptide K-(1-24)-peptide: storage and release by carcinoid tumors.

An antiserum directed against the COOH-terminal region of neuropeptide K-(1-24)-peptide that shows only 0.5% reactivity with neuropeptide K has been used in radioimmunoassay to study the posttranslation processing of human beta-preprotachykinin. A primary midgut carcinoid tumor contained high concentration of substance P (2970 pmol/g), neurokinin A (3660 pmol/g) and neuropeptide K-(1-24)-peptide (3430 pmol/g) but only a very low concentration (less than 5 pmol/g) of intact neuropeptide K. Neuropeptide K-(1-24)-peptide was also detected in extracts of metastatic tumor tissue from four patients with midgut carcinoid tumors. The amino acid sequence of tumor neuropeptide K-(1-24)-peptide was identical to that predicted from the nucleotide sequence of a human beta-preprotachykinin cDNA. The fasting plasma concentration of neuropeptide K-(1-24)-peptide was elevated in a patient with the carcinoid syndrome (821 fmol/ml compared with less than 18 fmol/ml in healthy subjects) and rose approximately 2-fold after intravenous pentagastrin. The study has demonstrated that the Lys25-Arg26 bond in neuropeptide K (corresponding to Lys96-Arg97 in the precursor) is an important processing site in human beta-preprotachykinin.

Aged↗
PubMedDate not supplied

Receptors for estrogen and progesterone in breast carcinoma in situ.

In contrast to the situation in invasive breast carcinoma, there are only few reports on the levels of receptors for estrogen (ER) and progesterone (PgR) in pre-invasive (in situ) breast carcinoma. In the present study ER and PgR levels were analyzed in 57 in situ human mammary carcinomas using a quantitative enzyme immunoassay method. Intraductal carcinoma was the dominating histopathological subgroup (75%). Within this subgroup the non-comedo and comedo variants comprised 66 and 34 percent respectively. Intralobular and papillary in situ subtypes were the second most frequent subgroups, representing 11% each. Using a cut-off level of 0.05 fmole/microgram DNA to define receptor poor and rich tumors we found that thirty-one out of the 57 cases (54%) were ER-rich. In the ER-rich tumors the receptor levels varied between 0.05 and 6.50 fmole/microgram with a mean concentration of 0.80 fmole/microgram DNA. Fifteen of 51 (30%) tumors were classified as PgR-rich tumors in which the levels ranged between 0.05 and 2.90 fmoles/microgram DNA, with a mean concentration of 0.45 fmoles/microgram DNA. Two thirds of the non-comedo, lobular and papillary variant were ER rich. A majority (80%) of comedo tumors were ER poor. Our findings show that 54% of in situ breast carcinomas have the molecular prerequisites for response to antiestrogen therapy which is of interest when planning adjuvant treatment protocols.

Breast Neoplasms↗