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Biomedical subjects

H Caglar

Publications and source records attributed to H Caglar.

16 recordsLinked to original sources
PubMed1991

Prospective trial of cisplatin, adriamycin, and dacarbazine in metastatic mixed mesodermal sarcomas of the uterus and ovary.

Twenty-four patients with advanced or recurrent uterine (13) and ovarian (11) mixed mesodermal sarcomas received a combination of cisplatin. Adriamycin and dacarbazine (PAD) as initial therapy after surgical debulking. Of the 13 patients with metastatic uterine sarcoma, six (46.1%) remained without evidence of disease (NED) from 8 to 36 months from the start of PAD. The estimated 1-, 2-, and 3-year survivals for these patients were 68%, 68%, and 51%, respectively. Of the 11 ovarian sarcoma patients, five (45.4%) were NED at 5, 7, 32, 56, and 59 months from the start of PAD. The estimated 1-, 2-, and 3-year survivals for these patients were 70%, 35%, and 35%, respectively. The PAD regimen is an active regimen in patients with metastatic uterine and ovarian mixed mesodermal sarcomas and progression-free survival may be improved by maximum debulking surgery prior to the initiation of PAD chemotherapy.

Aged↗
PubMed1991

Suburethral paraganglioma.

Masses presenting beneath the urethra are not uncommon. Besides ureteral diverticula, which account for the vast majority of these masses, a multiplicity of heterogeneous benign and malignant tumors have been encountered in this region. To the best of our knowledge, we report the first case of a neuroendocrine tumor, a paraganglioma, discovered in the anatomical compartment between the urethra and vagina. When evaluating a patient with a suburethral mass, it is important to consider paraganglioma as part of the differential diagnosis because unwitting surgical removal of a functional catecholamine-secreting tumor may precipitate a severe hypotensive episode and/or death.

Adult↗
PubMed1990

Pelvic radiation in stage I endometrial adenocarcinoma with high-risk attributes.

From 1977 to 1987, 45 patients with FIGO stage I endometrial adenocarcinoma with high-risk attributes and disease confined to the pelvis were prospectively treated with postoperative pelvic radiation. By study design, all patients underwent staging laparotomy with pelvic and paraaortic lymphadenectomy. All patients had either grade 1 or 2 adenocarcinoma and greater than 50% myometrial invasion or grade 3 adenocarcinoma with less than or greater than 50% myometrial invasion. The estimated 5-year survival for all 45 patients was 77% and the 5-year disease-free interval was 82%. Regional control was achieved in 89% of all patients, with 4% recurring at distant sites. When patients were stratified according to surgical-pathologic findings, 33 patients with disease confined to the uterus or uterus and pelvic nodes (surgical stage I) had estimated 5-year survival and disease-free interval of 88%. Of these 33 patients, 10 with grade 1 or 2 adenocarcinoma and deep myometrial invasion had 5-year disease-free intervals of 100%, while 23 patients with grade 3 adenocarcinoma with less than or greater than 50% myometrial invasion had disease-free intervals of 79 and 91%, respectively. From these results, it was concluded that patients with high-risk attributes demonstrated to have disease confined to the uterus or uterus and pelvic nodes can achieve excellent survival following surgical staging and postoperative pelvic radiation.

Adenocarcinoma↗
PubMed1986

Extracellular matrix-coated culture dishes: an in vitro model for primary human gynecologic tumors.

Culture dishes coated with an extracellular matrix (ECM) produced by bovine corneal endothelial cells were utilized to investigate human gynecologic carcinomas of epithelial origin. A high culture success rate was achieved for both solid tumor (83%) and ascitic fluid (75%) derived from specimens from 59 patients. Because of the high percentage of tumor cells attaching to the ECM and actively proliferating, a variety of in vitro studies (karyotypic analysis, morphologic appearance on ECM, and ability to digest the ECM) could be done. A preliminary in vitro profile of the various tumor cell types could be made on the basis of these studies. In addition, five long-term cultures were established utilizing the ECM model system.

Adenocarcinoma↗
PubMed1986

Partial and total skinning vulvectomy in treatment of carcinoma in situ of the vulva.

From July 1974 to December 1984, 24 skinning vulvectomies (17 partial and seven total) were performed in 24 patients with carcinoma in situ of the vulva. The objective for partial skinning vulvectomy was preservation of the cosmetic and functional integrity of the vulva in younger and sexually active patients in whom a steady increase in the incidence of vulvar intraepithelial neoplasia has been observed in the last decade. Two groups selected for partial skinning vulvectomy with skin graft were patients with multicentric vulvar intraepithelial neoplasia with colposcopic evidence of normal skin, and patients with localized but a wide surface area of vulvar intraepithelial neoplasia such that poor cosmetic results would be unavoidable should excision be approximated with primary skin closure. Only patients with involvement of the entire vulva were subjected to total skinning vulvectomy with total skin graft replacement. Recurrence and/or persistence were observed in two patients, both treated with total skinning vulvectomy. At present, all 24 patients remain free of detectable neoplasia on follow-up of six months to 11 years and all have very good cosmetic and functional results.

Adolescent↗
PubMed1986

Borderline malignant serous tumors of the ovary maintained on extracellular matrix: evidence for clonal evolution and invasive potential.

Four cases of advanced stage (II or III) and one case of early stage (IC) borderline malignant serous cystadenocarcinomas of the ovary were maintained on culture dishes coated with an extracellular matrix (ECM) produced by bovine corneal endothelial cells. Cells harvested for chromosomal analysis after 2-3 days showed diploid or near-diploid modalities in all cases. Banded chromosome studies in two cases revealed nonrandom clonal abnormalities with trisomy 2, 7, and 12 in seven of 13 metaphases. No structural abnormalities were noted. These cytogenetic findings differ from those found in malignant serous tumors of the ovary. In addition, borderline tumor cells digested the ECM in all cases and formed a cribiform pattern within a few days of primary culture. This study suggests clonal progression from early to advanced stages of borderline malignant serous tumors; readily distinguishable from overtly malignant serous tumors of the ovary. Ability of tumor cells derived from both primary tumors and metastatic implants to digest the ECM implies the possibility that borderline serous tumors have invasive potential.

Adult↗
PubMed1985

CO2 laser therapy for cervical intraepithelial neoplasia.

One hundred and fifty-six patients with cervical intraepithelial neoplasia (CIN) were treated with CO2 laser and followed for 2 1/2 to 6 years. There were 19 recurrences, of which 14 occurred in patients treated with a power density of less than 1000 W/cm2 to a depth of 6 mm. All of the recurrences were subjected to a second laser treatment. Overall failure rate was 4.5%. The incidence of acute bleeding during, and late bleeding 6 to 14 days following treatment, were 8 and 4%, respectively. Late bleeding occurred in patients who were treated with 800 to 1000 W/cm2 power density and to a 3 to 10 mm depth of destruction. Complications were directly and failures were inversely proportional to the power density and depth of destruction. Following therapy, the transformation zone was adequately seen in the majority of the patients.

Adolescent↗
PubMed1982

Vulvar intraepithelial neoplasia.

The authors reviewed the records of 50 patients with carcinoma in situ of the vulva seen at the State University of New York at Buffalo affiliated hospitals. Five patients (10%) were found to be immunosuppressed and 12 (24%) had other preinvasive and invasive genital or extragenital neoplasia. Of 43 patients whose symptomatology was available, almost half (46.5%) were asymptomatic. The most common symptom was vulvar itching in 18 (42%), and 32 (65%) patients had white vulvar lesions. Thirteen patients underwent vulvectomy, 23 underwent wide local excision, 8 underwent skinning and skin graft, 3 underwent topical 5-fluorouracil treatment, and 2 underwent CO2 laser treatment. On follow-up there were 6 patients with recurrent and/or persistent disease. Two recurrences followed wide local excision. Topical 5-fluorouracil failed in all 3 patients and CO2 laser failed in 1 of the 2 underwent laser treatment. There were 5 patients with invasive disease. In 3, diagnostic biopsy failed to reveal invasive neoplasia before surgical excision, and invasion was noted after 5-fluorouracil application in one and after CO2 laser treatment in another. All recurrences responded to therapy. In 41 patients followed up for 3 months to 11 years, there were no cancer-related deaths.

Adolescent↗
PubMed1982

Colposcopic patterns and their histopathologic correlation.

White epithelium, mosaicism, punctation, and atypical vessels are internationally used colposcopic terms describing an atypical transformation zone. Other morphologic findings are surface contour, clarity of demarcation, and tone of whiteness with or without atypical vessels. In the State University of New York at Buffalo affiliated hospitals, 665 cervical and vaginal atypical colposcopic patterns of 552 patients were matched with their histologic findings. Mosaicism, punctation, and white epithelium correlated with the histologic diagnosis of vaginal intraepithelial neoplasia and cervical intraepithelial neoplasia in 43%, 55%, and 42% of the cases, respectively. When white epithelium accompanied the mosaicism or punctation, the incidence of histologically confirmed vaginal and cervical intraepithelial neoplasia raised to 66% and 68%, respectively. In patients with prenatal DES exposure, mosaicism rarely (17%) correlated with the histologic findings of vaginal and cervical intraepithelial neoplasia. Overall, there was a great variability in the correlation depending on the specific colposcopic abnormalities.

Cervix Uteri↗
PubMed1981

Cytologic, colposcopic, and histologic correlation in young females.

The purpose of the reported study was to correlate the cytologic and colposcopic patterns with the histopathologic diagnosis. This was accomplished in 81 young females who underwent direct colposcopic biopsy because of suspicious appearance of the cervix and abnormal or suspicious cytology. Among them 17 were intrauterine DES-exposed females. The results of our study showed that the white epithelium plus punctuation, punctation alone, white gland openings, mosaism, white epithelium plus mosaism, white epithelium, and atypical vessels were the mot common findings compatible with cervical intraepithelial neoplasia (CIN). Cytology and colposcopy together as diagnostic procedures were the most suitable and successful combination for the diagnosis of CIN in young patients with suspicious appearance of the cervix.

Adolescent↗
PubMed1981

Topical 5-fluorouracil treatment of vaginal intraepithelial neoplasia.

In a prospective study, 27 patients with intraepithelial vaginal neoplasia diagnosed by colposcopically directed biopsies were treated with topical 5-fluorouracil. The cream was applied daily to the entire vagina until mucosal irritation occurred (5 to 10 days). Courses were repeated every 2 weeks for a total of 2 to 3 courses, which were considered 1 treatment, before response was evaluated. Those found to have persistent neoplasia as designated by positive vaginal cytology and/or colposcopically directed biopsies received a second 3-course treatment and were evaluated again. Except for 2 patients (1 who died from intercurrent disease during the treatment and another, evaluated prematurely after the first course of therapy, who was found to have persistent disease and was treated by other means), all patients responded with complete regression of vaginal intraepithelial neoplasia. Three patients developed reactivation of disease within 1 year, were retreated, and are currently completely free of disease. The authors believe the results of this study are very encouraging.

Administration, Topical↗
PubMed1978

Colposcopically directed cone biopsies in the management of cervical intraepithelial neoplasia.

Thirty-three patients with severe dysplasia and carcinoma in situ had a colposcopically directed cone biopsy in the operating room immediately prior to vaginal hysterectomy. In 3 cases (9%), the hysterectomy specimen showed the same type of residual disease as in the cone biopsy; in the remainder no residual disease was evident in the hysterectomy specimen. If colposcopically directed biopsies were performed, the long-term debate over the use of cone biopsy or hysterectomy for intraepithelial neoplasms would be resolved. Selected patients could be treated adequately by cone biopsy with a small number of patients requiring hysterectomy as indicated by direct examination with the colposcope.

Biopsy↗
PubMed1978

Survival and complications in cervical cancer treated by pelvic and extended field radiation after paraaortic lymphadenectomy.

Over a 3 year period, 49 patients with invasive cancer of the cervix underwent paraaortic lymphadenectomy. Of this group, 18 were stage lb, with cervix 3 cm or smaller, and were treated by radical hysterectomy. All had negative paraaortic nodes. The remaining 31 patients had more advanced disease and underwent radiation therapy in addition to the paraaortic lymphadenectomy. Thirteen patients with positive paraaortic nodes were treated with extended field radiation to the level of the diaphragms with 4,500 rad plus intracavitary radium applications. The remaining 18 patients with negative paraaortic nodes were treated to the fifth lumbar vertebra with 5,000 rad plus radium applications. The age of the patients and stage of the disease were similar for both groups. After 13-36 months of follow-up, the survival rate was 38% for patients with positive nodes compared to 72% for those with negative nodes. About half of both groups suffered complications. More study must be given to alternative treatments of advanced carcinoma of the cervix.

Cobalt Radioisotopes↗
PubMed1977

Paraaortic lymphadenectomy in gynecologic malignancies confined to the pelvis.

Eighty-six patients with pelvic malignancies had paraaortic node dissection; 30% had positive paraaortic lymph nodes. At the time of laparotomy, 77 patients had malignancies apparently confined to the pelvis after extensive work-up and histologic examination of tissue biopsies outside the pelvis; 20 (26%) had metastatic cancer in the paraaortic lymph nodes. Thirteen of 49 patients with cancer of the cervix, 5 of 18 with uterine cancer, and 2 of 10 with ovarian cancer had positive paraaortic lymph nodes. The value of paraaortic dissection in patients with pelvic malignancies apparently confined to the pelvis is discussed.

Female↗