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Biomedical subjects

E Petru

Publications and source records attributed to E Petru.

At least 55 records · Page 3Linked to original sources

[Hormone substitution in patients after primary treatment of gynecologic malignancies].

Hormone replacement therapy for postmenopausal patients following primary treatment of gynecologic malignancies has changed considerably during recent years. Estrogens have been found useful to prevent osteoporosis and cardiovascular disease as well as to ameliorate symptoms of estrogen deprivation. Thus, hormone replacement therapy can improve life quality of patients. Estrogen-gestagen replacement therapy after primary treatment of endometrial cancer is no longer contraindicated, at least in stage Ia to Ib disease. For breast cancer patients, the German Society of Senology has published recommendations based on the receptor status and lymph node status of an individual patient. Exogenous estrogens and gestagens are not contraindicated for breast cancer patients with negative receptors and negative lymph nodes. However, tamoxifen is indicated for patients with positive receptors and positive lymph nodes. If symptoms of hormonal deprivation occur, gestagens may be added to tamoxifen in these patients. There are no contraindications for hormone replacement therapy in patients with malignant tumors of the ovary, fallopian tube, cervix, vagina, and vulva.

Adult↗

Perioperative antibiotic prophylaxis in patients undergoing radical surgery for gynecologic cancer: single dose versus multiple dose administration.

A prospective, randomized study comparing single dose intravenous antibiotic prophylaxis with multiple-dose regimen in patients undergoing radical surgery for gynecologic malignancy was carried out. The majority of patients had cervical cancer. Thirty-seven patients in group A received one dose of 4 g piperacillin and 800 mg tinidazole 30 minutes before surgery. Twenty-nine patients in group B additionally received 4g piperacillin 8 hours and 4g piperacillin and 800 mg tinidazole 16 hours after the first dose. There were no significant differences between groups A and B with regard to median patient age, performance status, cardiologic and pulmonary status, or frequency of diabetes. There were also no significant differences between either group with regard to the parameters documented postoperatively, such as median hospital stay, leukocyte values, or febrile episodes. Forty-three per cent of patients in group A and 48% of patients in group B had no complications (p > 0.05). Twenty-three per cent of patients in group A and 31% of patients in group B developed infections (p > 0.05), 85% of which occurred in the urinary tract. The data suggest that a single dose of intravenous antibiotics is as effective as multiple dose administration in the perioperative prophylaxis in radical gynecologic surgery.

Anti-Bacterial Agents↗

Nongenital cancers metastatic to the ovary.

We review our experience with 82 patients with nongenital cancers metastatic to the ovary. All patients were referred for evaluation of an ovarian mass. The patients had primary carcinoma of the breast (n = 28), colon (n = 23), stomach (n = 22), pancreas (n = 7), or gallbladder (n = 2). The overall actuarial 5-year survival rate was 10%. Five-year survival in patients with metastatic colon cancer was significantly higher (23%) than that in patients with metastatic cancer of the breast, stomach, gallbladder, or pancreas, all of whom died within 58 months (P less than 0.05). Patients with unilateral metastatic ovarian involvement had a 5-year survival significantly better than that of those with bilateral involvement (28% vs 5%; p = 0.003). Five-year survival in patients with disease limited to the pelvis was significantly higher than that in those with abdominal spread (22% vs 6%; P less than 0.04). The 5-year survival of patients with residual disease less than 2 cm or greater than 2 cm in diameter was 18% or 4%, respectively (P = 0.002). This pattern applied mainly to differences in patients with primary cancer of the breast or colon (P less than 0.008). These data suggest that an aggressive surgical effort seems to be indicated in colon cancer metastatic to the ovary, as some of these patients may survive 5 years.

Breast Neoplasms↗

[Primary, papillary serous carcinoma of the peritoneum; a report of experiences].

A total of fourteen patients with primary papillary serous carcinoma of the peritoneum (PPSCP) were treated at the Department of Obstetrics and Gynaecology of the University of Graz between 1980 and 1991. The presence of tumours from other sites, particularly the pancreas and the ovary, had been excluded. Due to extensive spreading of the disease mainly in the upper abdomen, only seven of the 14 patients underwent exploratory laparotomy. The median overall survival time was 10 months (range, 1-28 months). These results are due to the extent of spreading of the disease at diagnosis, and also to the fact, that optimal cytoreductive surgery was possible only in four of the 14 patients. The four patients with optimal cytoreduction showed a better survival than those, who underwent less radical surgery. These results seem to indicate, that, as in primary ovarian cancer, the amount of residual disease may be an important prognostic determining factor in PPSCP.

Adult↗

Remission induction with carboplatin-epirubicin-prednimustine followed by consolidation radiotherapy in advanced ovarian cancer.

Adjuvant chemoradiotherapy was administered to 26 patients with stage Ic-IV ovarian cancer after radical cytoreductive surgery. All patients received six cycles of carboplatin, epirubicin, and prednimustine and had no clinical evidence of disease after completion of chemotherapy. They received whole-abdominal radiation and radiation to the retroperitoneal lymph nodes. This protocol was discontinued for five (23%) patients because of myelosuppression, progressive disease, or withdrawal. One patient had a small bowel obstruction due to intraperitoneal adhesions. The survival of ten stage-III ovarian cancer patients, who received chemoradiotherapy and were evaluable for assessment of treatment efficacy, was retrospectively compared with the survival of 11 stage-III patients who received chemotherapy only. At 36 months, a slight advantage of the chemoradiotherapy versus the chemotherapy-only group was observed (p = 0.11). These preliminary results suggest that adjuvant chemoradiotherapy may prolong the "no evidence of disease" interval of radically operated ovarian cancer patients. Toxicity is acceptable when second-look surgery is avoided and when subsequent radiotherapy is limited to patients with no evidence of disease.

Antineoplastic Combined Chemotherapy Protocols↗

Treatment of chemically induced autochthonous rat mammary and colorectal carcinomas with interleukin-2.

The antineoplastic efficacy of human interleukin-2 (IL-2) in autochthonous methylnitrosourea-induced mammary carcinoma and in acetoxymethyl-methyl-nitrosamine-induced colorectal carcinoma of Sprague Dawley rats has been investigated. Under the conditions applied, IL-2 was non-toxic. In the mammary carcinoma IL-2 was therapeutically inactive. In the colorectal carcinoma, 1200 U IL-2/day exhibited significant antitumour activity in established tumours as well as in tumours treated "prophylactically" before their manifestation (P less than 0.05). The effect of IL-2 seemed to be more pronounced when given before manifestation of colorectal tumours (T/C = 8.7% vs 17.8% in established tumours). The differential sensitivity of the autochthonous mammary and colorectal carcinoma may be explained by differences in their proliferation rates and differences in volumes at the beginning of IL-2 therapy. IL-2 seems to be preferentially active in small tumours with a low proliferation rate, a feature typical of colon tumours.

Animals↗

Metabolism of debrisoquine and susceptibility to breast cancer.

There may exist an association between the genetically determined oxidation status of the antihypertensive agent debrisoquine (DEB) and the propensity to develop tumours. The metabolism of DEB is extensive in 90% of healthy subjects (metabolic ratio = MR = 0-12.6; MR = % DEB excreted divided by % 4-hydroxy-DEB excreted) and poor in 10% (MR greater than 12.6). In patients with cancer of the lung, urinary bladder, and gastrointestinum, the percentage of high metabolizers is increased to greater than 98%. The poor metabolizer mode is almost devoid of cancer patients. It was investigated whether breast cancer patients show a similar association with respect to the oxidative status of DEB. 108 breast cancer patients and 123 women with benign gynecologic disorders received 1 tablet of 10 mg DEB orally in the evening. Urine was collected for the subsequent 8 hrs and analysed for its content of DEB and its main urinary metabolite 4-OH-DEB by means of HPLC. No decreased amount of poor metabolizers was seen in the cancer group.

Breast Neoplasms↗

Long-term survival in stage III and IV ovarian cancer.

A total of 104 unselected, previously untreated patients with invasive stage III or IV ovarian cancer were operated on between 1977 and 1984. Nine patients were lost in follow-up, three died from non-malignant disease. Thirteen of the 92 eligible patients (15%) were observed to survive 5 years or longer. In the 13 long-term survivors, 4 had stage IV disease, 7 positive peritoneal cytology, 3 bowel resection, and 12 residual disease less than 2 cm after primary surgery. Retroperitoneal lymph nodes were involved in 6/9 cases. The majority of 5-year survivors (69%) received cis-platin-containing combination chemotherapy. 5/7 long-term survivors had positive second-look. At 5 years, life-quality in 9/13 patients who were free of disease, was high. It can be concluded that only patients with optimally resected stage III or IV ovarian cancer have a realistic chance of long-term survival. It is expected that increasing radicality n surgery for ovarian cancer together with platinum-based chemotherapy regimens may improve long-term survival in the future. In addition, further studies of new chemotherapeutic approaches are needed.

Adult↗

Characterization of in vitro chemosensitivity of perioperative human ovarian malignancies by adenosine triphosphate chemosensitivity assay.

We report the in vitro chemosensitivity of primary and recurrent human ovarian tumor samples analyzed by adenosine triphosphate chemosensitivity assay. We defined sensitivity as a greater than or equal to 70% decrease in intracellular adenosine triphosphate versus control at 20% of the reported peak plasma concentration per agent tested. Twenty of 21 assays (95.24%) were completed successfully. Single-agent and combined dose-response patterns consisting of decreasing viability with increasing drug concentration were observed consistently. Thirteen primary tumors were assayed, with 15.4% sensitive to cisplatin, 7.7% sensitive to 4-hydroxycyclophosphamide and 53.8% sensitive to their combination. Seven recurrent tumors were assayed, with 14.3% sensitive to cisplatin, 28.6% sensitive to 5-fluorouracil, and 42.9% sensitive to their combination. Dose-response characteristics and in vitro sensitivity rates reported in this article are consistent with reports of patient response in the literature. We conclude that adenosine triphosphate chemosensitivity assay is an efficient and reliable instrument for the in vitro chemosensitivity assessment of human tumors and warrants further clinical investigation.

Adenosine Triphosphate↗

Pretherapeutic scalene lymph node biopsy in ovarian cancer.

To study scalene lymph node involvement in ovarian cancer, 37 patients with this disease underwent pretherapeutic open sampling of the left scalene fat tissue. Only 1 patient had a palpable supraclavicular mass. Positive scalene nodes were found in 7 (22%) of 32 patients with stage III or IV disease. Three of four patients with positive scalene nodes also had both positive pelvic and positive paraaortic nodes; one patient with stage IV disease had negative pelvic and paraaortic nodes. Demonstration of scalene node involvement per se currently does not alter the management of patients with ovarian cancer, although patients with occult involvement of the scalene nodes could be considered ineligible for intraperitoneal chemotherapy.

Adult↗

Consolidation radiotherapy following carboplatin-based chemotherapy in radically operated advanced ovarian cancer. A pilot study.

Adjuvant chemoradiotherapy was administered to 26 patients with stage Ic-IV ovarian cancer after radical cytoreductive surgery. All patients received six cycles of carboplatin, epirubicin, and prednimustine and had no evidence of disease after completion of chemotherapy. They received whole-abdominal radiation and radiation to the retroperitoneal lymph nodes. Five (23%) of the patients were discontinued on this protocol because of myelosuppression, progressive disease, or withdrawal. One patient had a small bowel obstruction due to intraperitoneal adhesions. The survival of 10 Stage III ovarian cancer patients who received chemoradiotherapy and were evaluable for assessment of treatment efficacy was retrospectively compared with the survival of 11 Stage III patients who received chemotherapy only. At 36 months, a slight advantage of the chemoradiotherapy versus the chemotherapy-only group was observed (p = 0.11). These preliminary results suggest that adjuvant chemoradiotherapy may prolong the "no evidence of disease" interval of radically operated ovarian cancer patients. Toxicity is acceptable when second-look surgery is avoided and when subsequent radiotherapy is limited to patients with no clinical evidence of disease.

Antineoplastic Combined Chemotherapy Protocols↗