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F van Coevorden

Publications and source records attributed to F van Coevorden.

16 recordsLinked to original sources
PubMed1997

The role of radiotherapy in the local management of dermatofibrosarcoma protuberans. Soft Tissue Tumours Working Group.

Dermatofibrosarcoma protuberans (DFSP), a fibrohistiocytic tumour of intermediate malignancy, has a strong tendency to recur locally. Wide local excision is the recommended treatment modality. A retrospective analysis was performed on 38 consecutive DFSP patients presenting to The Netherlands Cancer Institute, to define the role of radiotherapy. Of the 21 patients treated surgically (all with negative resection margins) seven recurred, a local control probability of 67%. Combined modality treatment was given to 17 patients. Prior to radiotherapy, these patients experienced 33 occurrences of DFSP, but after irradiation only three recurrences were seen, a local control probability of 82%. These results are in keeping with the recent literature where increasing value is being given to both adjuvant and curative radiotherapy in the local management of DFSP. We recommend radiotherapy in DFSP patients where repeated surgery may cause mutilation or functional impairment.

Adult↗
PubMed1996

Surgical treatment of lung metastases: The European Organization for Research and Treatment of Cancer-Soft Tissue and Bone Sarcoma Group study of 255 patients.

BACKGROUND: Several reports have shown a prolonged survival after surgical treatment of pulmonary metastases from soft tissue sarcomas. However, it is still unclear which prognostic factors predict a favorable outcome. Series are not comparable and the data are conflicting. Therefore, a multi-institutional study was undertaken to analyze prognostic factors in selecting patients for resection of pulmonary metastases from soft tissue sarcomas. METHODS: This report is a retrospective study of the European Organization for Research and Treatment of Cancer-Soft Tissue and Bone Sarcoma Group. Two hundred fifty-five patients underwent complete resection of lung metastases from soft tissue sarcomas. Cases with chondrosarcoma and small round cell sarcomas like Ewing sarcoma were excluded. RESULTS: The 3 year and 5 year overall postmetastasectomy survival rates were 54% and 38%, respectively. The disease free postmetastasectomy survival rates were 42% and 35%, respectively. Analysis of prognostic factors for a more favorable outcome revealed disease free intervals of 2.5 years or more, following a resection with microscopically free margins, age less than 40 years, and Grade I and II tumors. These prognostic factors have an independent influence on overall survival, using a multivariate Cox regression model. CONCLUSIONS: Surgical excision of lung metastases from soft tissue sarcomas is well accepted and should be considered as a first line of treatment if preoperative evaluation indicates that complete clearance of the metastases is possible. Further investigation is needed before chemotherapy can be recommended as additional therapy.

Adolescent↗
PubMed1995

Lymphedema-induced lymphangiosarcoma.

A series of eight patients with chronic lymphedema-related lymphangiosarcoma is presented. All but one case showed a typical rapid progression and fatal outcome, as has been reported in other series. In one patient the lymphangiosarcoma developed on the chest wall, the axilla and the arm where persisting lymphedema and fibrosis occurred after bilateral mastectomy and bilateral postoperative radiotherapy. In this patient an asymptomatic course and slow locoregional progression of lesions was seen. The clinical picture, the etiological considerations and the therapeutic options of the lymphedema-induced lymphangiosarcoma with regard to the literature are discussed.

Aged↗
PubMed1994

Resectable retroperitoneal soft tissue sarcomas. The effect of extent of resection and postoperative radiation therapy on local tumor control.

BACKGROUND: Soft tissue malignancies of the retroperitoneum are rare. Surgery is commonly considered the first choice of treatment. There is still no consensus concerning the precise value of the extent of surgery and the value of additional treatment modalities. METHODS: From 1973 to 1990, 34 patients were initially treated by surgery for retroperitoneal soft tissue sarcomas at the Netherlands Cancer Institute. In a retrospective study, the prognostic effect of extent of primary surgery and postoperative radiation therapy was examined. RESULTS: Liposarcomas (47%) and leiomyosarcomas (29%) were the histologic types most commonly found. Grade of malignancy was defined as medium to high (II/III) in 44% and as low (I) in 38%. Complete (extended or marginal) resection of the tumor was achieved in 29 patients. After complete resection, the 5-year survival rate and the local recurrence rate were 35% and 63%, respectively. Extended surgery (performed in eight patients) showed a local recurrence rate of 50%. Thirteen patients received high-dose postoperative radiation therapy, which was found to have a significant favorable effect on the recurrence-free interval (P < 0.01). CONCLUSIONS: We conclude that complete (extended) resection followed by high-dose postoperative radiation therapy improves the prognostic outcome of patients with retroperitoneal soft tissue sarcomas.

Adult↗
PubMed1994

Surgical treatment of pulmonary metastases from soft tissue sarcomas: a retrospective study in The Netherlands.

Sixty-seven of 87 patients with soft tissue sarcoma underwent complete resection of the metastases in the lung. In this retrospective study, follow-up was for a median of 24 months. The 5-year overall, crude and disease-free survival was 38%, 45%, and 41%, respectively. Twenty-seven (40%) patients developed a recurrence in the lung. Of the six prognostic variables, the only factor significantly related to disease-free survival was grade. It is concluded that surgery for lung metastases of soft tissue sarcoma should be considered as standard therapy when preoperative evaluation predicts a complete resection. By adding chemotherapy to surgery, an improvement of prognosis probably can be achieved.

Follow-Up Studies↗
PubMed1994

Management of bowel obstruction in patients with advanced ovarian cancer.

In a retrospective study, 58 patients with bowel obstruction due to advanced ovarian cancer were analysed. In a forward stepwise proportional hazard regression analysis, we looked for factors influencing bowel obstruction-free survival. Patients who presented with bowel obstruction as the first sign of ovarian cancer and those with a longer interval between last cancer treatment and bowel obstruction did better. Patients with ascites did worse. No other independent factors were found. Based on these data, we classified patients into a favourable prognosis group (no previous treatment or interval since last treatment exceeding 6 months; no ascites) and a poor prognosis group (interval since last treatment shorter than 6 months; ascites). Patients from the favourable prognosis group had a median bowel obstruction-free survival of 8 months, compared to 1 month for the poor prognosis group (P < 0.001). Surgery had a marginally significant positive effect on bowel obstruction-free survival when compared to medical treatment in the favourable prognosis group (P = 0.052). Surgery had no effect at all in the poor prognosis patients.

Adult↗
PubMed1994

Repeated resection of recurrent pulmonary metastatic soft tissue sarcoma.

A series of nine patients who presented with recurrent lung metastases from soft tissue sarcoma after pulmonary surgery were treated with a second or further thoracotomy. There were no postoperative deaths. The median interval between the first and second thoracotomy was 23 months. Four patients underwent three or more operations. Post-thoracotomy survival was 24-209 months after the first thoracotomy. Five patients are alive after repeated thoracotomies more than 10 years after initial treatment of the primary STS. It is concluded that in cases of recurrent lung metastases from STS repeated thoracotomy is the best therapy if all metastases can be removed completely.

Humans↗
PubMed1992

Dermal angiosarcoma of the breast: a complication of primary radiotherapy?

A 70-year-old female developed recurrent disease following radiotherapy for primary inoperable breast cancer 5.5 years previously. Salvage mastectomy was performed. Pathology revealed recurrent breast cancer, along with a second primary malignancy, a dermal angiosarcoma. Radical excision of recurrent angiosarcoma failed. Irradiation combined with hyperthermia showed good palliation. The angiosarcoma's possible relation to the initial radiotherapy is discussed.

Aged↗
PubMed1992

A rare case of Riedel's thyroiditis, 6 years after retroperitoneal fibrosis: two diseases with one pathogenesis?

We describe a 70-yr-old female patient in whom both a retroperitoneal fibrosis and 6 years later a Riedel's thyroiditis were diagnosed. Both diseases belong to the group of fibrotic diseases called "multifocal fibrosis". Retroperitoneal fibrosis is now known to be an auto-allergic reaction to lipid components of the atherosclerotic process in the abdominal aorta, resulting in a fibrotic reaction around it. We hypothesize that similarly Riedel's thyroiditis is in fact a periarteritis of the carotid artery, resulting in cervical fibrosis, secondarily involving the thyroid. This hypothesis would account for the occurrence of these two rare diseases in one patient.

Aged↗
PubMed1986

Combined endoscopic and surgical treatment in Peutz-Jeghers syndrome.

A combined endoscopic and surgical treatment in Peutz-Jeghers syndrome is presented. Natural history in Peutz-Jeghers syndrome often leads to multiple and acute laparotomies, resulting in intestinal resections. This may lead to a short bowel syndrome. In order to gain control over the small intestinal polyposis, a combined approach by the gastroenterologist and surgeon is performed. At laparotomy, an endoscope is introduced orally into the small intestine which is then telescoped over it by the surgeon. The small intestine is inspected in retrograde order and existing polyposis is treated by endoscopic or surgical polypectomy, or both, or by minimal intestinal resection. Thus, a "clean small intestine" is created. Data on five patients thus treated are presented. No recurrences were seen after this procedure at a mean follow-up period of 21 months. Combined endoscopic and surgical treatment of Peutz-Jeghers syndrome, together with top and tail endoscopy, results in a "clean intestine" and is supposed to diminish the need for multiple acute laparotomies and, therefore, the risk of a short bowel syndrome. There is also supposed to be an improvement in the quality of life and life expectancy.

Adolescent↗
PubMed1982

Pre-operative whole-gut irrigation with mannitol.

Whole-gut irrigation preceded by oral mannitol administration as a method of preoperative bowel preparation was studied in 58 patients. Our results did not confirm the advantages described in the literature. Irrigation time, irrigation fluid volume, patient acceptability and the quality of bowel preparation were not improved, compared to our earlier studies with saline alone. Fluid retention was considerably diminished after mannitol preparation. A significant increase in postoperative septic complications was observed. Disadvantages and possible hazards of mannitol administration are discussed. Mannitol cannot be recommended as a safe and useful adjunct in whole-gut irrigation.

Abdomen↗
PubMed1982

Surgical problems in continuous ambulatory peritoneal dialysis (CAPD).

The surgical technique of implantation of peritoneal catheters for continuous ambulatory dialysis (CAPD) is described and the catheter-related complications are discussed. Our experience with 37 implanted catheters in 27 patients is presented. No mortality was encountered in our series in relation to implantation and CAPD.

Adolescent↗