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Biomedical subjects

E A Surwit

Publications and source records attributed to E A Surwit.

88 records · Page 5Linked to original sources
PubMed1981

Mitomycin-C, bleomycin, vincristine, and cis-platinum in the treatment of advanced, recurrent squamous cell carcinoma of the cervix.

A combination chemotherapy regimen containing mitomycin-C (10 mg/m2, day 2), vincristine (0.5 mg/m2, days 1 and 4), bleomycin (30 U QD, days 1--4 as a continuous intravenous infusion during courses one and two only), and cis-platinum (50 mg/m2, days 1 and 22) was administered every 6 weeks to 14 evaluable patients with advanced (i.e., Stage IVB) and/or recurrent squamous cell carcinoma of the cervix. Four patients (29%) achieved a complete response, lasting 8, 9.5+, 17+, and 21+ months. Three of these patients have had complete disappearance of their pulmonary metastases and one has had resolution of a large left-sided pelvic wall mass. Two additional patients (14%) had a partial response to therapy, each lasting 1.5 months. The median survival for these 14 patients was 9.0 months. The chemotherapy regimen was well tolerated. There were no drug-related deaths and no instances of severe or irreversible renal dysfunction or peripheral neuropathy. The mean lowest white blood cell and platelet counts were 4540 and 205,000 per mm3, respectively. Although severe or life-threatening thrombocytopenia occurred in only 36% patients, it appeared to be the dose-limiting toxicity of this drug combination.

Bleomycin↗
PubMed1981

Adjunctive radiation therapy in the management of stage I cancer of the endometrium.

One hundred fifty-two patients with stage I, grades 2 and 3 adenocarcinoma of the endometrium, treated in 1972 and 1973 at the Radiumhemmet, are presented. Two uterine packings followed at 4 to 6 weeks by total abdominal hysterectomy and bilateral salpingo-oophorectomy resulted in a 5-year survival of 89%, whereas patients treated primarily with surgery followed by vaginal cylinder irradiation demonstrated 90% survival. Patients in both groups received whole pelvis irradiation postoperatively for deep myometrial invasion (more than 50% invasion by viable tumor). Patients treated with radiation therapy alone had 57% survival. Optimal results in poorly differentiated (grade 3) carcinoma of the endometrium were achieved with preoperative packings (90% survival); only 12% of the patients required external radiation therapy postoperatively.

Adenocarcinoma↗
PubMed1980

Late recurrences of gestational trophoblastic neoplasia.

Presented are two cases of recurrence of gestational trophoblastic neoplasia more than 1 year after apparently successful therapy. Both patients initially had had nonmetastatic disease, were clinically free of disease, and had had repetitively negative serum radioimmunoassay titers for the beta subunit of human chorionic gonadotropin for 2 to 3 years. The development of these late recurrences re-emphasizes the need for prolonged follow-up monitoring of patients after apparently successful therapy for gestational trophoblastic neoplasia.

Adult↗
PubMed1980

In-vitro clonogenic assay for predicting response of ovarian cancer to chemotherapy.

95 clinical trials of anticancer drugs were done in 40 patients with advanced ovarian cancer who had undergone an in-vitro soft-agar human tumour stem-cell assay for drug sensitivity. In the 95 clinical trials, 13 of 21 patients responded clinically to drugs predicted to be effective in vitro, while in 73 of 74 instances in which drug resistance had been predicted in vitro there was no response to treatment. 2 patients achieved a complete remission of 1 and 12+ months and 11 had partial remissions lasting a median of four months. Prediction of in-vitro resistance was 99% accurate. The 62% complete or partial remission rate to agents with proven in-vitro efficacy was achieved in extensively pretreated ovarian cancer patients who were unlikely to respond to empirically chosen secondary agents. The human tumour stem-cell assay, in which ovarian tumour colony-forming units are grown in a two-layer agar-culture system incorporating tests for drug sensitivity or resistance, can be effectively used to plan a suitable chemotherapy regimen for ovarian cancer patients.

Adenocarcinoma↗
PubMed1980

Treatment of metastatic trophoblastic disease with poor prognosis.

Fifty-one patients are presented who were treated for poor-prognosis gestational trophoblastic disease by physicians at Duke University Medical Center (Southeastern Regional Trophoblastic Disease Center) between 1968 and 1978. Disease in 72% (37 of 51 patients) is currently in remission (8 months to 10 years). Treatment was primarily by multiagent chemotherapy, with adjunctive surgery and radiation therapy in selected patients. Unsuccessful chemotherapy prior to treatment at this center, a prolonged interval from the antecedent pregnancy to treatment, and liver metastases portended a worse prognosis in these patients.

Adolescent↗
PubMed1979

Choriocarcinoma following term pregnancy.

Two hundred and sixty-five patients with malignant trophoblastic disease were admitted to the Southeastern Trophoblastic Disease Center at Duke University Medical Center between July 1966 and June 1976. Of these 165 patients, 20 had choriocarcinoma following a term gestation with a survival rate of 60% as compared to 95% survival rate for the remaining 245 patients. Previously described risk factors of initial human chorionic gonadotropin (hCG) titer of greater than 100,000 IU/24 hr urine, duration of symptoms for more than 4 months, significant prior unsuccessful chemotherapy or cerebral or hepatic metastases identified the "poor prognosis" group. Post-term gestation "poor prognosis" patients had a significantly lower cure rate (47%), than other patients with "poor prognosis" for gestational trophoblastic disease (75%; P less than 0.05). Post-term gestation choriocarcinoma has a propensity for more extensive metastatic spread and would appear to be less responsive to conventional chemotherapy, which may be due to an altered immune response in these patients. This suggests that an antecedent term pregnancy should be added to the previously described high-risk factors for patients with malignant trophoblastic disease.

Adult↗
PubMed1978

Adenoid cystic carcinoma of the Cervix. Report of 9 cases and a reappraisal.

The clinical and pathologic findings of 9 patients with adenoid cystic carcinoma of the cervix are presented. A review of the literature identified an additional 29 cases. The tumor was usually associated with adenocarcinoma or squamous cell carcinoma of the cervix. Adenoid cystic carcinoma of the cervix appears to be an aggressive type of tumor; of the 38 cases reported in the literature lung metastases have occurred in 18 (47.4%), and of these, 14 patients are known to have died of the cancer.

Aged↗
PubMed1978

Stage II carcinoma of the endometrium. An analysis of treatment.

An analysis of 41 patients with histologically documented Stage II adenocarcinoma of the endometrium treated between 1969 and 1974 is presented. The 3-year survival for all patients was 46%. Patients treated with radiation therapy alone (tandem, ovoids, and external radiation therapy) had 29% survival while patients treated with radiation therapy and surgery had a 71% survival. For all patients, survival by grade was 80% (Grade I), 36% (Grade II), and 20% (Grade III). Among those patients with recurrent disease, 40% of cases were in the pelvis while 20% were isolated distal recurrences. Patients with stromal invasion of the cervix had a 30% survival while patients without stromal invasion had a 67% survival. An analysis of these data, along with a review of the literature, reveals that 1) hysterectomy plays a critical role in survival, 2) invasion of the cervical stroma would appear to be a requisite criteria for the establishment of Stage II disease, and 3) aggressive radiation therapy with uterine packings (Heyman capsules) should be attempted in those patients who are not surgical candidates.

Adenocarcinoma↗
PubMedDate not supplied

Laparoscopic staging of endometrial cancer: the learning experience.

OBJECTIVE: To evaluate our learning-curve experience with laparoscopic management of endometrial carcinoma. METHODS: Retrospective review of our first 125 patients with endometrial cancer who were managed laparoscopically. The patient population was reviewed in a chronological manner, noting patient demographics, operative procedure and times, estimated blood loss, hospital stay, complications, and pathology. RESULTS: Overall, the mean age was 68.6 years (range 29-89), the mean weight was 160 pounds (range 97-328), and the mean Quetelet index was 27.8 (range 17.8-56.4). Metastatic disease was discovered in 28.8% (17/59) of patients with grade 2 or 3 lesions. There was no statistically significant variation in any of these parameters throughout the study. Operative times for staging without lymphadenectomy decreased significantly from a mean of 163 minutes to 99 minutes (p < .001). Operative times for staging with lymphadenectomy decreased from a mean of 196 minutes to 128 minutes (p < 0.02). Hospital stay decreased from a mean of 3.2 days in the first quarter of our study to 1.8 days (p < .0001). The overall average complication rate of 4% (two enterotomies, two cystotomies, and a transected ureter) did not vary. However, the rate of conversion to laparotomy dropped significantly from 8% (2/25) to 0% (0/100). CONCLUSIONS: We found that operative times and hospital stays for laparoscopic staging of endometrial cancer continued to drop after 125 cases. While the ability to detect metastatic disease and the rate of major complications appear unrelated to length of the operator experience, the conversion rate to laparotomy decreases with operator experience. Learning-curve parameters must be recognized by physicians, patients, and researchers for a host of reasons.

Adult↗