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Biomedical subjects

C A Stringer

Publications and source records attributed to C A Stringer.

At least 37 records · Page 2Linked to original sources
PubMed1987

Treatment of metastatic stromal tumors of the ovary with cisplatin, doxorubicin, and cyclophosphamide.

From September 1981 until June 1986, eight patients with metastatic ovarian stromal tumors were entered into a prospective phase II study to determine the efficacy of a chemotherapy regimen combining cisplatin, doxorubicin, and cyclophosphamide. Patients received cisplatin 40-50 mg/m2 intravenously (IV), doxorubicin 40-50 mg/m2 IV, and cyclophosphamide 400-500 mg/m2 IV, all on day 1 every 28 days. The median age was 43 years (range 24-65 years). Two patients had stage II disease, one had stage III, and five had recurrent disease (original stage: four stage I and one stage III). The median number of chemotherapy cycles was six (range four to 14). Three patients (38%) had a complete response to therapy (two confirmed by second-look laparotomy), and two patients (25%) achieved a partial response (one verified by second-look laparotomy). The overall response rate was 63%. Toxicity was minimal. Four patients are disease-free at 13+ to 48+ months, one patient is alive with disease at six+ months, and three patients are dead of tumor at four, 17, and 36 months from the start of chemotherapy. These results indicate that the combination of cisplatin, doxorubicin, and cyclophosphamide has modest activity in the treatment of metastatic ovarian stromal tumor.

Adult↗
PubMed1987

Ureteral assessment after radical hysterectomy.

Postoperative intravenous pyelography was performed in 233 patients with stage IB cervical carcinoma treated with radical hysterectomy and pelvic lymphadenectomy between January 1962 and December 1985. Four patients developed symptoms of ureteral injury, two (0.8%) ureteral fistulae, and one (0.4%) stricture and obstruction due to recurrent carcinoma. No ureteral injuries were observed in 229 asymptomatic patients. A 5.2% incidence of transient severe ureteral dilatation occurred in asymptomatic patients, but resolved within a median of 94 days. A significant urinary tract anomaly was observed in 3.4% of preoperative pyelograms. All of these anomalies were apparent at surgery and presented no intraoperative difficulties. Three patients (1.3%) sustained intraoperative ureteral transections, which were diagnosed and repaired without sequelae. In patients with early cervical carcinoma having primary operative treatment, the role of routine preoperative and postoperative intravenous pyelography is questionable.

Adult↗
PubMed1986

Cisplatin, vinblastine, and bleomycin combination therapy in resistant gestational trophoblastic disease.

Eleven patients were treated with cisplatin, vinblastine, and bleomycin (PVB) combination chemotherapy after failure of conventional triple-agent therapy with methotrexate, dactinomycin, and cyclophosphamide for gestational trophoblastic disease. Of ten evaluable patients, five (50%) achieved negative titers. Sustained remission was achieved in only two patients (20%). Major hematologic toxicities and two deaths due to sepsis occurred in this group of patients. Although this combination does exhibit activity, its clinical use in the treatment of refractory trophoblastic disease is limited.

Adult↗
PubMed1986

Treatment of malignant nondysgerminomatous germ cell tumors of the ovary with vinblastine, bleomycin, and cisplatin.

Fifteen patients with malignant nondysgerminomatous germ cell tumors of the ovary seen at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston, were treated with a combination of vinblastine, bleomycin, and cisplatin (VBP). All patients underwent initial surgery: biopsy alone in one patient, unilateral salpingo-oophorectomy in ten patients, and bilateral salpingo-oophorectomy with or without hysterectomy in four patients. Seven patients received VBP as primary postoperative therapy. One patient died of progressive disease at 15 months following diagnosis. The other six patients are alive without evidence of disease 9 to 47 months from the time of diagnosis. Eight patients received VBP as second-line treatment; three patients had a complete response to therapy and are surviving disease-free 41 to 71 months from the time of diagnosis. Four patients treated secondarily had a partial response; three of these patients subsequently developed progressive disease and died, while one patient survived after undergoing salvage therapy with an etoposide-containing regimen. One patient had no discernible response to VBP therapy and died. The VBP regimen represents an aggressive, moderately toxic, short-term combination regimen that has promising activity against malignant germ cell tumors of the ovary.

Adolescent↗
PubMed1986

Endodermal sinus tumor of the ovary associated with pregnancy.

The association of endodermal sinus tumor of the ovary with pregnancy is a rare event. Reported is a patient with stage Ic endodermal sinus tumor diagnosed in the 25th week of gestation. She received two cycles of combination chemotherapy consisting of vinblastine, bleomycin, and cisplatin, and delivered a healthy male infant by cesarean section at 32 weeks' gestation. She subsequently completed three more cycles of chemotherapy and remains alive and well. This is the first reported case of a patient with endodermal sinus tumor treated with combination chemotherapy during pregnancy that had a successful outcome for both mother and infant. The literature concerning the association of endodermal sinus tumor and pregnancy and the use of chemotherapy during pregnancy is reviewed.

Adult↗
PubMed1986

Adenoid cystic carcinoma of Bartholin gland.

Five cases of adenoid cystic carcinoma of the Bartholin gland, a rare vulvar tumor, are reviewed with respect to clinical and pathological characteristics. Histologic transition from normal Bartholin gland to adenoid cystic carcinoma was evident in two cases. Two patients developed the tumor in association with pregnancy. Local recurrences are common and may precede distant metastases, pulmonary being the most common. Patients with repetitive local recurrence or pulmonary metastases may have slowly progressive disease and survive for many years. This is reflected in the disparity between the progression-free interval and survival curves. The recommended primary treatment is wide local excision, obtaining clear margins, and an ipsilateral inguinal lymphadenectomy.

Adult↗
PubMed1985

Treatment of malignant nondysgerminomatous germ cell tumors of the ovary with vincristine, dactinomycin, and cyclophosphamide.

Eighty patients with malignant nondysgerminomatous germ cell tumors of the ovary were treated with the combination of vincristine, dactinomycin, and cyclophosphamide (VAC) at The University of Texas M.D. Anderson Hospital and Tumor Institute. All patients underwent initial surgery: biopsy alone in 3 patients, unilateral salpingo-oophorectomy in 48 patients, and bilateral salpingo-oophorectomy with or without hysterectomy in 29 patients. Sixty-six patients received VAC as primary postoperative therapy; 46 patients (70%) achieved a sustained remission. VAC produced sustained remission in 86% of patients with Stage I, 57% of patients with Stage II, 50% of patients with Stage III, and no patients with Stage IV disease. For patients with Stage I disease, survival rates did not differ among histologic groups, but in advanced disease, patients with immature teratoma did significantly better than the others. Four of the 20 patients who failed primary VAC therapy were salvaged with other therapies, and 8 of 14 treated with VAC after relapse or failure of other treatments were salvaged. Although VAC produces excellent results with very acceptable toxicity in patients with Stage I disease and advanced immature teratoma, survival of patients with other advanced histologic types has been disappointing. The authors are therefore treating this latter group with alternative therapy such as vinblastine, bleomycin, and cisplatin with the goal of achieving improved efficacy.

Adolescent↗
PubMed1985

Alveolar rhabdomyosarcoma of the female genitalia.

Eight cases of alveolar rhabdomyosarcoma of the female genitalia were diagnosed from 1963 to 1983 at The University of Texas M. D. Anderson Hospital. The primary sites were vulva in two, perineum in five, and broad ligament in one patient. When possible, therapy was initiated with local tumor excision (five patients). Surgery was followed by local or regional radiation (six patients) and chemotherapy (seven patients). Of the eight patients, five died within 9 months, one died 27 months after diagnosis, and only two are 5-year survivors. The aggressive behavior of this tumor is evidenced by autopsy findings of widespread metastases. Metastatic disease to the bone was present in four patients and to the breast in three patients. Local disease was controlled in two patients who died of distant metastases. Current therapy recommendations include excisional surgery, local radiation, and combination chemotherapy. A need for more effective chemotherapeutic programs is evident.

Adolescent↗
PubMed1985

Postpartum osteitis pubis.

We have presented a rarely described case of osteitis pubis occurring in a postpartum period. This rapidly progressive, nonsuppurative osteonecrosis of the symphysis pubis is frequently confused with other entities. Because the prognosis for recovery is invariably good, acute intervention is directed at relieving pain by immobility and anti-inflammatory agents.

Adult↗
PubMed1985

Sarcoma botryoides of the female genital tract.

Results of treating 14 patients with sarcoma botryoides of the female genital tract are reviewed. Nine patients were younger than four years old and five were older than 14. Primary tumors were in the vagina (eight), cervix (three), vulva (one), and cervicovaginal region (two). All but one patient underwent surgery, including wide local excision (one), vaginectomy (one), hysterectomy (one), hysterectomy and vaginectomy (two), anterior exenteration (two), and total pelvic exenteration (six). A combination of vincristine, actinomycin-D, and cyclophosphamide was the chemotherapy regimen most frequently administered. Only one of the nine patients receiving chemotherapy died from recurrence. One patient with disease too extensive for surgery received intraarterial vincristine and radiation therapy; 16 years later she developed an adenosquamous carcinoma of the uterus. Sarcoma recurred in three patients. This review of patients treated between 1956 and 1983 reflects the evolution of therapy over 30 years. Conservative surgery alone was inadequate; therefore, radical (exenterative) surgery was adopted; recently less extensive surgery has been combined with chemotherapy, producing satisfactory results.

Adolescent↗
PubMed1984

Fetal growth sustained by parenteral nutrition in pregnancy.

Severe maternal nutritional deprivation has been associated with intrauterine growth retardation, premature labor, and increased perinatal mortality and morbidity. The authors present four cases in which total parenteral nutrition was used successfully to support fetal growth in such diverse complications as twin pregnancy with maternal jejunoileal bypass, regional enteritis, and acute pancreatitis. Maintenance of fetal growth as evidenced by serial sonographic examination allows achievement of fetal lung maturation before delivery. In all the cases presented there was no perinatal mortality or morbidity. The main clinical implication of the report is the possible application of total parenteral nutrition to maintain adequate growth in fetuses small for gestational age because of maternal nutritional deprivation.

Adolescent↗
PubMed1984

Intrapartum maternal lumbosacral plexopathy.

Maternal intrapartum neurologic injuries are infrequently reported in modern obstetric practice. Two cases are presented and methods of evaluating the level of injury to differentiate this syndrome from peroneal nerve palsies are suggested. The long-term prognosis of lumbosacral plexus injuries encountered during labor and delivery appears to be favorable. Nonetheless, future intrapartum management of these patients should be conservative.

Adult↗