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Biomedical subjects

H P Schultz

Publications and source records attributed to H P Schultz.

At least 19 recordsLinked to original sources
PubMed2001

Metastatic Ewing sarcoma/PNET of bone at diagnosis: prognostic factors--a report from Saudi Arabia.

BACKGROUND: To evaluate outcome and prognostic factors in Saudi Arabian patients with metastatic Ewing sarcoma and PNET of bone (PMES) at diagnosis. PROCEDURE: Ninety-nine of 304 (33%) consecutive patients with Ewing sarcoma and PNET of bone registered at our centre from 1975 to 1998, had metastatic disease at registration and 93 were available for analysis. The maximum x-axis diameter of the primary tumor was used as the measure of primary tumor size. Usually a trial of systemic treatment was undertaken before a decision was made on local treatment. Standard chemotherapy regimens were used in all treated patients. Forty-one (44%) patients did not receive radical local treatment due to an inadequate response to chemotherapy, or a decision not to undertake more than palliative treatment. Radical treatment of the primary site was radiation alone 41 (79%), resection alone 7 (13%), and resection and radiation 4 (8%). RESULTS: The 5-year survival rates were 9% for all 93 evaluable patients, 16% for 52 patients who received chemotherapy and radical local treatment, 0% for 41 patients who received lesser treatment, 19% for 43 patients with lung metastases alone, and 0% (P = 0.002) for 50 patients with other sites involved. For 60 patients with imaging data, 5-year survivals were 34 and 0% when the maximum transverse diameter of the primary tumor was < 10 cm (N = 20) and > or = 10 cm (N = 40), respectively. CONCLUSIONS: Small primary tumor size and the presence of lung metastases alone were the only significant favorable prognostic factors. Earlier diagnosis will be the basis for better results.

Adolescent↗
PubMed1992

Neutron therapy in Saudi Arabia: an overview and results of dose searching study in head and neck cancer.

The King Faisal Specialist Hospital and Research Centre is the only center in the Middle East that incorporates a neutron therapy facility. The neutron beam is produced by a cyclotron, which produces a beam by either a (d(15)+Be) or (p(26)+Be) reaction. The beam from the proton reaction is selected for therapy because of its superior physical characteristics. These were verified by an intercomparison conducted by the European Organization for Research on Treatment of Cancer (EORTC) Heavy Particle Therapy Group. Full beam data are presented. The first study in the neutron therapy Program is on the treatment of squamous cancers of the head and neck. This consists of two parts. Part I is a dose searching phase and Part II is a comparison of our current photon treatment versus neutrons using the neutron dose selected by Part I of the study. Results of the dose searching phase (Part I) are presented.

Carcinoma, Squamous Cell↗
PubMed1984

Small cell anaplastic carcinoma of the lung. The Aarhus experience 1976-1981.

Over a 6-year period 179 patients with small cell carcinoma of the lung (SCLC), 152 with limited disease, 25 with extensive disease, and 2 who were not staged, were treated with chest irradiation and combination chemotherapy with CCNU, adriamycin and vinblastine. For all patients the 2-year survival was 19.9 +/- 3 per cent, and the 5-year survival 11.9 +/- 3 per cent. No patients with extensive disease survived for 5 years. This type of treatment has curative potential for SCLC limited disease, which calls for further trials based on this approach.

Aged↗
PubMed1984

Testicular germ cell tumours in Denmark 1976-1980. Pathology of 1058 consecutive cases.

In the first five-year period of the Danish Testicular Carcinoma Study (DATECA) 1058 consecutive testicular germ cell tumours were examined. Of these, 554 were seminomas comprising 515 of typical type, 26 anaplastic and 13 spermatocytic; 497 were non-seminomas comprising 145 pure tumours and 352 mixed tumours of various types. Among the various subtypes of non-seminomas embryonal carcinoma (EC) was recorded in 87 per cent, endodermal sinus tumour (yolk sac tumour; EST) in 22 per cent, teratoma (T) in 55 per cent and choriocarcinoma (CC) in 17 per cent. Only very few tumours were pure EST or pure CC. Five tumours were recorded as 'others or uncertain'. The tumours were graded with regard to various histologic features. Moderate and severe necrosis, bleeding, and a large number of mitoses were significantly more frequent in non-seminomas. The presence of tumour tissue at the resection margin was also more frequent in non-seminomas. Tumours with a largest diameter of less than 2.5 cm had already caused metastases in 16 per cent of the seminomas and 29 per cent of the non-seminomas. Increasing size of the tumours was associated with increasing frequency of metastatic disease but this association was not directly proportional. Distribution of the various histologic types according to the stage of disease varied. Thus, 78 per cent of the seminomas presented in stage I while 54 per cent of the non-seminomas had localized disease. Anaplastic seminomas were distributed similarly to the non-seminomas while all spermatocytic seminomas, with one exception, were recorded as stage I. Of non-seminomatous subtypes pure EC was associated with the highest frequency of stage III, followed by mixed tumours containing CC components. Although the present series is large the heterogeneity of germ cell tumours demands further investigation of larger numbers to confirm some of the findings.

Adult↗
PubMed1984

Testicular carcinoma in Denmark 1976-1980. Stage and selected clinical parameters at presentation.

Since Jan. 1, 1976 practically all new cases of germ cell tumours of the testis in Denmark have been included in the Danish Testicular Carcinoma Study (DATECA), permitting detailed registration of data concerning histology and stage at the time of diagnosis. The incidence of carcinoma of the testis in Denmark continues to be high with a crude rate of 8 to 9/100 000 males per year. During the past 5 years the size of the primary tumours has decreased. Parallel to this, the rate of metastatic spread has decreased for seminoma, while no such change has been observed for non-seminomatous tumours. Data are presented on histology and stage for 1058 consecutive patients.

Adolescent↗
PubMed1984

Non-seminomatous testicular germ cell tumours in Denmark 1976-1980. Results of treatment.

Over a 5-year period (1976-1980) 499 patients with non-seminomatous testicular germ cell tumours were included in the Danish Testicular Carcinoma Study (DATECA). The 3-year crude survival for patients in clinical stages I, II and III was 91, 77 and 45 per cent, respectively. In stage I the relapse-free survival for patients given radiation combined with bleomycin and vincristine was significantly higher than that for patients given radiation alone. No difference in the crude survival was observed. For stage II patients maintenance chemotherapy following radiation combined with bleomycin and vincristine did not improve relapse-free or crude survival. The survival of patients with non-seminomatous tumours improved significantly during the 5-year period. This improvement was probably due to the introduction of cis-platinum in the treatment.

Adult↗
PubMed1984

Testicular seminoma in Denmark 1976-1980. Results of treatment.

Over a five-year period the DATECA Study included 554 consecutive patients with seminoma, representing practically all cases in the country. The stage distribution was: stage I 424 patients, stage II 110 patients, and stage III 17 patients. Typical seminoma was registered in 515 patients, anaplastic seminoma in 26 patients, and spermatocytic seminoma in 13 patients. The treatment was post-operative irradiation except in a few very advanced cases who received chemotherapy. Three-year corrected survival was: stage I 99 per cent, stage II 89 per cent, and stage III 65 per cent. Anaplastic seminoma showed a significantly higher rate of metastatic spread than typical seminoma and the prognosis was worse. Treatment-related complications were few, but adjuvant bleomycin combined with irradiation of advanced seminoma resulted in 2 deaths from pneumonitis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Prognostic factors in testicular germ cell tumours. Experiences from 1058 consecutive cases.

Prognostic factors in carcinoma of the testis were studied in 1058 adult patients treated in Denmark from 1976 to 1980. Separate analyses of the prognostic factors were carried out within the subgroups formed by a classification of the patients according to main histologic type (seminoma, non-seminoma) and the clinicoradiologic stage (I, II and III). The prognosis was measured by relapse-free survival (stage I and II), and survival (stage II and III). The prognostic value of 19 clinical and histologic parameters was evaluated using logrank tests and multiple regression analyses. An elevated HCG level and the size of retroperitoneal metastases were associated with a significantly adverse prognosis for seminoma in stage II. For non-seminomas the following parameters had a significant influence on the prognosis. Stage I: postoperative HCG level, local invasion and number of mitoses. Stage II: size of retroperitoneal metastases, postoperative HCG level, tumour size and local invasion. Stage III: presence of liver or lung metastases, postoperative HCG level, presence of choriocarcinoma or endodermal sinus tumour, and age.

Adult↗
PubMed1984

Tumour markers in testicular germ cell tumours. Five-year experience from the DATECA Study 1976-1980.

Since Jan. 1, 1976, nearly all new cases of testicular germ cell tumours have been included in the Danish Testicular Carcinoma Study (DATECA), and have been monitored by the tumour markers alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG). During the first five years, 1058 patients participated in the investigation, but only 603 of these patients were followed by preoperative as well as postoperative marker determinations in serum. The overall prevalence of marker positivity, i.e. elevated preoperative values for AFP and/or HCG, was 8 per cent for seminoma patients and 60 per cent for non-seminoma patients. Elevated levels of serum AFP and HCG were correlated to the presence of endodermal sinus tumour and choriocarcinoma elements, respectively, in the primary tumour. The presence of increased marker concentration in serum was correlated stage (higher percentage in higher stages) and to prognosis (marker negative patients had a better prognosis than marker positive patients). Marker production by seminoma patients seems to indicate a poor prognosis, especially for HCG producing seminomas.

Chorionic Gonadotropin↗
PubMed1984

Non-seminomatous testicular germ cell tumours. Preliminary analysis of ongoing trials in the DATECA Study.

This report deals with the preliminary results of trials in the DATECA project with stage I, II and III patients with non-seminomatous germ cell tumours. Stage I patients were randomized between infradiaphragmatic irradiation and observation. No significant difference in recurrence rates has been observed as yet. Eighteen of 95 patients had recurrence with a median time to relapse of 3 months. Fifteen patients achieved complete remission after treatment by combination chemotherapy while 3 patients are still undergoing treatment. Stage II patients received 6 series of cis-platinum, bleomycin, and vinblastine. The patients were initially randomized to receive chemotherapy alone versus chemotherapy plus irradiation. Irradiation led to increased toxicity and decreased doses of the antineoplastic drugs. Fifty-one patients were studied. The overall complete remission rate was 89 per cent including 7 patients who achieved complete remission after secondary surgery. Three patients died from testicular tumours and two toxic deaths occurred in this group. Stage III patients were treated with 6 series of cis-platinum, bleomycin, and vinblastine. Fifty patients were studied. The complete remission rate was 72 per cent including 2 patients who achieved complete remission after secondary surgery. Sixteen patients relapsed after achieving complete remission with a median time to relapse of 4 months. Eight of these died, 4 achieved a new complete remission, while 4 patients are still under treatment. Sixty per cent of the patients are at present alive without evidence of disease, while 12 patients died from testicular tumours and 2 from toxic side effects.

Actuarial Analysis↗