Biomedical subjects

F M Abbas

Publications and source records attributed to F M Abbas.

9 recordsLinked to original sources

PubMed2001

A vaginal and extraperitoneal approach to surgically stage patients with endometrial cancer.

OBJECTIVE: The purpose of this project was to prospectively evaluate the feasibility of an alternative technique for surgically staging patients with endometrial cancer. METHODS: Patients with endometrial cancer were enrolled in this protocol from September 1999 until August 2000. The staging procedure included pelvic washings via colpotomy, total vaginal hysterectomy, bilateral salpingo-oophorectomy (TVH/BSO), and extraperitoneal pelvic and paraaortic lymphadenectomy (EP-LND) if indicated. Tumor characteristics, time and feasibility of surgical procedures, length of hospital stays, and complications were prospectively recorded. RESULTS: Twenty-one patients were enrolled. Grade 1, 2, and 3 tumors were identified in 6 (29%), 10 (48%), and 5 (24%) patients, respectively. Pelvic washings and TVH/BSOs were performed on all patients. A total of 21/21 (100%) uterine specimens were removed vaginally and 41/42 (98%) adnexa were resected vaginally. EP-LNDs were performed on 17 (81%) patients due to pathologic findings of the uterine specimens. The median time to perform a TVH/BSO was 68 (47-149) min. The median time to complete a EP-LND was 77 (59-107) min. The median number of postoperative days was 1 (1-5). Complications were infrequent and mild. CONCLUSIONS: TVH/BSO, pelvic washings, and EP-LND is a feasible alternative to standard surgical staging of endometrial cancer. The minimal amount of exposure to the intraperitoneal space makes this approach arguably the least invasive for endometrial cancer staging and accounts for the decrease in recovery time and shortened hospital stays. The acceptable length of surgical time, short hospital stays, and minimal requirements for surgical instruments make this approach potentially the most cost-effective option for surgically staging patients with endometrial cancer. A randomized trial comparing this technique to standard surgical staging is warranted.

Aged↗

PubMed2001

Associations between smoking and adenocarcinomas and squamous cell carcinomas of the uterine cervix (United States).

OBJECTIVES: Few studies of smoking and cervical carcinoma have addressed the rare cervical adenocarcinomas or used DNA-based tests to control for human papillomavirus (HPV) infection. METHODS: This multicenter case-control study included 124 adenocarcinoma cases, 307 community controls (matched on age, race, and residence to adenocarcinoma cases), and 139 squamous carcinoma cases (matched on age, diagnosis date, clinic, and disease stage to adenocarcinoma cases). Participants completed risk-factor interviews and volunteered cervical samples for PCR-based HPV testing. Polychotomous logistic regression generated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for both histologic types. RESULTS: Eighteen percent of adenocarcinoma cases, 43% of squamous carcinoma cases, and 22% of controls were current smokers. After control for HPV and other questionnaire data, adenocarcinomas were consistently inversely associated with smoking (e.g. current: OR = 0.6, 95% CI 0.3-1.1; > or = 1 pack per day: OR = 0.7, 95% CI 0.4-1.3), while squamous carcinomas were positively associated with smoking (e.g. current: OR = 1.6, 95% CI 0.9-2.9; > or = 1 pack per day: OR = 1.8, 95% CI 1.0-3.3). Results in analyses restricted to HPV-positive controls were similar. CONCLUSION: Smoking has opposite associations with cervical adenocarcinomas and squamous carcinomas. Although both histologic types are caused by HPV and arise in the cervix, etiologic co-factors for these tumors may differ.

Adenocarcinoma↗

PubMed2000

Use of the ultrasound surgical aspirator in ovarian cancer: a case-control study.

BACKGROUND: This study was undertaken to evaluate the use of the ultrasound surgical aspirator in ovarian cancer and to determine if cytoreduction was improved with its use. METHODS: The study is a retrospective case control trial. Twenty-six consecutive ovarian cancer patients who had the ultrasound surgical aspirator used during their surgery were retrospectively compared to 25 consecutive ovarian cancer patients who did not have the ultrasound surgical aspirator used during their surgeries. The latter group had their surgeries immediately before the ultrasound surgical aspirator was introduced into the hospital. Both groups were similar in age, stage, histology type, grade, and median number of chemotherapy cycles. RESULTS: Patients that had the ultrasound surgical aspirator used had a 69% optimal cytoreduction rate compared to 16% in the control group (p = .001). This was statistically significant (p = 0.001). Survival time was equal in both groups. CONCLUSIONS: Results of the study showed that use of the ultrasound surgical aspirator may permit more patients to be optimally cytoreduced.

Case-Control Studies↗

PubMed1999

Oral contraceptives as risk factors for cervical adenocarcinomas and squamous cell carcinomas.

To assess the hypothesis that oral contraceptives (OCs) increase the risk of cervical adenocarcinomas, we conducted a six-center case-control study of 124 patients with adenocarcinomas, 139 with squamous cell carcinomas, and 307 population controls. Women between the ages of 18 and 69 who were newly diagnosed with cervical adenocarcinomas between 1992 and 1996 were eligible. Healthy female controls and a second case group of incident cervical squamous cell carcinomas were matched to the adenocarcinoma cases. All participants were interviewed regarding OCs, other risk factors for cervical carcinoma, and utilization of cytological screening, and a PCR-based test determined HPV genotype of cervical samples for both case groups and controls. Use of OCs was positively and significantly associated with adenocarcinomas and positively but weakly associated with squamous cell carcinomas. Associations between OCs and invasive adenocarcinomas (n = 91), squamous cell carcinoma in situ (n = 48), and invasive squamous cell carcinomas (n = 91) disappeared after accounting for HPV infection, sexual history, and cytological screening, but a positive association remained between current use of OCs and cervical adenocarcinoma in situ (n = 33). This association persisted after stratification by screening and sexual history and after restriction according to HPV status, but small numbers made it difficult to exclude detection bias, selection bias, or residual confounding by HPV as potential explanations Current OC use was associated with cervical adenocarcinomas in situ, but we saw no other evidence that OCs independently increase the risk of cervical carcinomas.

Adenocarcinoma↗

PubMed1998

Cost, quality of life and outcome measures in ovarian cancer.

As research into cancer intensifies and treatments proliferate, life-interval gained is no longer a question of simply measuring time. Ovarian cancer patients, especially, have benefited from efforts to develop feasible screening processes and the new treatment modalities for this type of cancer. Within the last decade, medicine has come to realize that survival intervals and cure rates are useless to patients if they cannot retrieve out of the process at least some aspects of their lives before cancer and for as long a period of time as possible. This article focuses on measuring and assessing the effects of treatment in terms of outcome and quality of life from the patient's perspective. Medicine as a science, and being a science, has not been comfortable in taking into account intangibles when assessing its own performance and success rates. However, the roles of caregivers and health providers have been rapidly evolving from that of treating the disease to treating the patient, and often the patient's family, with all that implies.

Cost of Illness↗

PubMed1997

Gynecologic oncology patients in the surgical ICU. Impact on outcome.

OBJECTIVE: To determine the risk factors and outcome for survival of gynecologic oncology patients in the surgical intensive care unit (SICU). STUDY DESIGN: A chart review from January 1987 through May 1992 yielded 73 gynecologic oncology patients with a malignancy who had undergone surgery with a minimum stay of three days in the SICU. Of these 73 patients, 49 patients died of malignancy, 5 were alive with disease, and 19 were alive without evidence of disease. RESULTS: The median survival of the 73 patients was 123 days; that of 48 ovarian cancer patients was 50 days. Twenty patients (27.4%) died in the hospital. CONCLUSION: This study, with multivariate analysis, showed that multiple medical conditions, especially cardiac disease, and a stay of longer than five days in the SICU had a significant impact on survival, with ovarian cancer patients staying longer and having poorer survival. These results will help in triaging patients for postsurgical management.

Adult↗

PubMed1997

Prolonged stays of OB/GYN patients in the surgical intensive care unit. A cost-benefit analysis.

OBJECTIVE: To delineate costs between various obstetric and gynecologic (OB/GYN) patients with stays in the surgical intensive care unit (SICU). STUDY DESIGN: A chart review identified 86 OB/GYN patients who had a minimum SICU stay of three days between January 1987 and May 1992. RESULTS: Our study showed that the total cost of these cases was $3,344,010, with a median of $29,780 (range, $20,230-180,610) and that the difference between patients with malignancies and those without (median, $20,340) was not statistically significant (P = .11). However, cases of malignant disease that had either a prexisting medical condition or an SICU stay of more than five days cost more than any other cases (P = .038). The SICU share of total hospital cost ranged from 20.7% in patients with malignancy to 40% in patients without malignancy. CONCLUSION: As health care costs come under closer scrutiny, the critically ill patient should not be placed at risk of lessened chances of survival because perceived savings result in decreasing quality of care.

Adult↗

PubMed1994

Selective vascular embolization in benign gynecologic conditions.

Eight patients with benign obstetric and gynecologic conditions required embolization. There was a total of 11 embolizations, and embolizing agents were chosen depending on the abnormality requiring embolization. Gelfoam, Ivalon and alcohol were used to treat vascular malformations. Ovarian veins were embolized with coils. Postoperative bleeding was managed with Gelfoam, coils and/or Ivalon. Four patients had bleeding after hysterectomy or vaginal suspension. One patient had postdelivery bleeding. All the bleeding was controlled after embolization. A uterine arteriovenous malformation was managed with embolization, allowing the patient to carry her next pregnancy to term. The symptoms of a vulvar hemangioma and ovarian syndrome were controlled with vascular embolization. Morbidity was minimal. Embolization is the primary treatment of choice in obstetric and gynecologic patients with postoperative bleeding or symptomatic vascular malformation.

Angiography↗

PubMed1993

Transvaginal color Doppler sonography of adnexal masses: differences in blood flow impedance in benign and malignant lesions.

OBJECTIVE: The purpose of this study was to assess the blood flow characteristics of adnexal masses before surgical excision and to determine whether color flow Doppler sonography is useful for distinguishing benign from malignant masses. SUBJECTS AND METHODS: Thirty-one adnexal masses were evaluated with color flow Doppler transvaginal sonography. The pulsatility index and resistive index were calculated from the waveforms generated from blood flow within the ovary. Twenty-five lesions were benign and six were malignant on pathologic examination. Benign lesions included six endometriomas, six mesothelial cysts, three serous and one mucinous cystadenoma, three mature cystic teratomas, two hemorrhagic corpus luteum cysts, one cystadenofibroma, one sclerosing stromal cell tumor, one paratubal cyst, and one ovary that had undergone torsion with infarction. The malignant lesions consisted of three papillary serous cystadenocarcinomas, one granulosatheca cell tumor, one immature teratoma, and one metastasis of colon cancer to the ovaries. RESULTS: Benign tumors and cysts had a significantly higher pulsatility index (mean, 1.93 +/- 1.02; range, 0.23-3.99) and resistive index (mean, 0.77 +/- 0.22; range, 0.2-1.0) than did malignant tumors (pulsatility index: mean, 0.77 +/- 0.33; range, 0.31-1.09; resistive index: mean, 0.5 +/- 0.17; range, 0.27-0.67). However, some overlap in individual values for benign and malignant lesions was found. CONCLUSION: Our preliminary data suggest that high pulsatility and resistive indexes indicate benign adnexal processes; however, considerable overlap in pulsatility and resistive indexes between benign and malignant lesions was noted, and further work is needed before the validity of these factors is proved.

Adnexal Diseases↗