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Biomedical subjects

D Stuhldreher

Publications and source records attributed to D Stuhldreher.

9 recordsLinked to original sources
PubMed1997

Report of 337 patients with renal cell carcinoma emphasizing 110 with stage IV disease and review of the literature.

BACKGROUND: In the literature, the interdependence of variables, including stage, sex, age, tumor size, therapy, and survival, is complex. The size variable has heretofore received relatively little emphasis. METHOD: This was a retrospective evaluation of 337 patients with kidney cancer treated at the University of Illinois Affiliated Hospitals. Data were collected on stage, sex, age, tumor size, TNM stage, therapy, and survival. Statistical analyses included Kaplan-Meier 5-year survivals, as well as multivariate analysis utilizing the Cox regression model. A subset of 110 patients with TNM Stage IV disease is further evaluated employing a multivariate analysis. The principal form of therapy was nephrectomy. RESULT: Five-year survivals by stage varied from 100% for Stage I, 96% for Stage II, 59% for Stage III, to 16% for Stage IV. In the subset of 110 patients with TNM Stage IV disease, those with a single metastasis had better survivals than those with two or more. Those having nephrectomy had better survivals (P < 0.05). Therapy (in addition to nephrectomy) was curative (defined as cytotoxic chemotherapy or immunotherapy) in 40 patients and palliative (defined as radiation to bone metastases, hormone therapy, or supportive) in 70 patients. Multivariate analysis of TNM Stage IV variable differences indicated that only tumor size differences and nephrectomy significantly affected survival. CONCLUSIONS: Of importance is the observation that among these patients. Survival is directly correlated with tumor size.

Adenocarcinoma↗
PubMed1995

Renal cell carcinoma: comparison of the TNM and Robson stage groupings.

This review compares the two major staging systems for renal cell carcinoma: the TNM and Robson systems. For purposes of worldwide clinical and scientific consistency, the TNM system is recommended. However, the primary tumor size cutoff of 2.5 cm. does not prognostically differentiate between stages I and II. A review of 337 patients with renal cell carcinoma, of whom 122 had stage I or II disease revealed that a 2.5-cm cutoff did not predict survival differences, while cutoffs of 5.0, 7.5, and 10.0 cm did. Because 7.5 cm most closely approximates the mean renal cell cancer diameter as noted by SEER data, it is recommended that the TNM primary tumor cutoff be changed to 7.5 cm.

Carcinoma, Renal Cell↗
PubMed1994

Stage IV renal cell carcinoma.

Data from 104 patients with stage IV renal cell carcinoma were evaluated to investigate relationships between survival and gender, race, age, tumor size, lung versus bone metastasis, number of metastatic sites and nephrectomy. No statistically significant differences in survival were found between gender or racial groups, nor was there a statistically significant relationship between survival and patient age. Survival tended to decrease as tumor size increased. Survival was worse for patients with multiple metastatic sites compared to those with only 1 metastatic site, and for patients with bone and lung metastases compared to those with lung but no bone metastases and bone but no lung metastases. Although nephrectomy patients appeared to have somewhat better survival rates than those without nephrectomy, this difference was apparently due to better prognostic factors for nephrectomy patients.

Adolescent↗
PubMed1994

Value of tumor size in predicting survival from renal cell carcinoma among tumors, nodes and metastases stage 1 and stage 2 patients.

Results in the literature are inconsistent regarding the value of tumor size in predicting survival from renal cell carcinoma, and its use as a staging variable in the current tumors, nodes and metastases system has been questioned. In this study tumor size had no prognostic significance in Kaplan-Meier or Cox regression models examining survival differences between 93 patients with stage T1N0M0 and T2N0M0 renal cell carcinoma dichotomized by tumor size cutoffs at 2.5, 5, 7.5 or 10 cm. In multivariate Cox regression models for 122 patients with stage T1NallMall or T2MallMall renal cell carcinoma, metastatic disease was the strongest predictor of survival, and patients with smaller tumors had significantly longer survival than those with larger tumors at all cutoffs except 2.5 cm., for which differences were insignificant. A 5 cm. cutoff maximized the value of tumor size in predicting survival. If tumor size is to remain the variable by which tumors, nodes and metastases stages T1 and T2 disease are differentiated, a 5 cm. cutoff should replace the current 2.5 cm. definition.

Carcinoma, Renal Cell↗
PubMed1994

Prevalence of sperm bound antibodies in infertile men with varicocele: the effect of varicocele ligation on antibody levels and semen response.

An increased level of antisperm antibodies has been demonstrated in infertile men with varicocele compared with normal fertile men, suggesting a possible cause and effect relationship. To evaluate the possible etiological role of antisperm antibodies in varicocele patients, we performed a prospective study of 32 infertile men undergoing varicocele ligation. Semen analyses and antisperm antibodies as measured by the immunobead test were performed preoperatively and postoperatively at 3 and 6 months. Of the infertile men with varicocele 28% had a positive immunobead test compared with 0% of normal fertile men. The average total motile sperm count was significantly different (p < 0.05, 2-tailed t test) for 9 varicocele patients with sperm-bound antibody (3.2 x 10(6)) compared with 23 without antibody (8.4 x 10(6)). Postoperatively, 68% of all patients exhibited improved semen parameters, with no change in antibody status in either group. Among the antibody positive group 71% showed an increase in motile sperm per ml. of 2.8 x 10(6) to 17.2 x 10(6) (525% increase, p < 0.05), while in the antibody negative group 67% showed an increase of 3.8 x 10(6) to 24.9 x 10(6) (553% increase, p < 0.05). Our study suggests that there is an increased incidence of sperm-bound immunoglobulin in infertile varicocele patients and an apparent adverse effect on semen parameters in these patients. However, the presence of sperm-bound immunoglobulin did not affect the percentage response to surgical correction, nor can we postulate an immunological mechanism as a major etiological factor in varicocele induced infertility.

Adult↗
PubMed1993

Renal cell carcinoma: the size variable.

Three hundred and thirty-seven renal cell carcinomas treated at University of Illinois Affiliated Hospitals were reviewed. There was an inverse correlation between tumor size and survival.

Carcinoma, Renal Cell↗
PubMed1992

Microsurgical approach to the abdominal thoracic duct in the rat: considerations in the collection of lymphocytes.

In experiments involving the collection of thoracic duct lymphocytes the anatomy of the abdominal thoracic duct in the rat has been further defined. In general, the abdominal thoracic duct lies posterior and to the left of the aorta between the renal arteries and the diaphragm. There are variations in the microsurgical approach to the classically described location of this organ that should be noted by investigators attempting to identify and dissect this structure.

Animal Welfare↗
PubMed1992

The effect of BCG on thoracic duct lymphocytes.

Adoptive immunotherapy is becoming increasingly more important in the management of advanced malignancies. This report describes the results of immunomodulation therapy with BCG in the Dunning tumor. In addition it describes new techniques in the harvesting of lymphocytes. Thoracic duct lymphocytes from 34 rats were evaluated for the effect of the presence of the Dunning R-3327 AT-3 tumor as well as for the response to bacillus Calmette Guerin (BCG). Both tumor and BCG resulted in significant changes in the helper/suppressor T cell ratios.

Animals↗