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Biomedical subjects

J Baltzer

Publications and source records attributed to J Baltzer.

At least 55 records · Page 3Linked to original sources

[Malignant melanomas of the vulva].

In 13 patients, mean age 57 (31-78) years, with malignant melanoma of the vulva, 7 of the tumors occurred on the Labia majora, 4 on the Labia minora and 2 on the clitoris. 8 cases involved nodular malignant melanomas, 2 cases each involved a superficial-spreading form and an acrolentiginous form, and one case involved a non-classifiable malignant melanoma. According to histological criteria 10 of 13 tumors showed a high risk of metastasising. At the time of diagnosis one of the patients was in stage II and one in stage III of the disease. Of the 13 patients, 6 died, as a result of the tumor, 5 within the first 2 years. The mean survival time was 15 (6-28) months. In three other cases the disease has reached an advanced stage: stage Ib, II or III. Up to now only 4 patients have remained symptom free, the symptom free interval averaging 62 (33-84) months. This investigation confirms the special characteristics of malignant melanomas of the vulva, which are the predominance of tumors having a bad prognosis and the rapidly progressing course of the disease.

Adult↗

[Diagnostic conization in clinical cervix cancer].

Various methods of tissue sampling are used to verify histologically a clinical carcinoma of the cervix. The question arises whether or not diagnostic cone biopsy has any influence on the treatment and/or the clinical course of this disease. The clinical and histological data and the follow-up of 185 patients with squamous cell carcinoma of the cervix were statistically evaluated. We found no difference between patients with or without cone biopsy in respect of complications, frequency of metastases or recurrences, and survival. However, our deliberations permit the following statement: cone biopsy is an appropriate method to diagnose cervical intraepithelial neoplasia (CIN) or microcarcinoma of the cervix and may--under certain conditions--even be the adequate therapy. However, cone biopsy lacks any advantage over other diagnostic methods if it is employed merely for the purpose of histological verification of clinical carcinoma of the cervix.

Adult↗

[Initial experiences with the "Mammotest" stereotactic diagnosis system in the diagnosis of roentgenologically unclear changes in the breast].

The article reports on first experiences with the stereotactic diagnosis device "Mammotest" in the diagnosis of diseases of the breast. Preoperative stereotactic carbon marking of non-palpable changes requiring clarification via mammography was successful in 94% of the cases. With the stereotactic cytological clarification by means of Nordenström's cannula the high rate of cellular material which could not be clarified, was unsatisfactory. Stereotactic histological punch biopsy in case of unclear mammographic findings enables exact localisation of the punch and histological examination of the punch biopsy. Mammographic follow-up did not yield any false negative finding to date.

Biopsy, Needle↗

[Postoperative complications following gynecologic operations in elderly females with benign and malignant changes of the genitals].

The retrospective study reported here, which covered 2116 patients operated on, indicates that postoperative complications are more likely to occur in women aged over 60 than in younger patients. There is also a connection between the patient's age and previous internal disease, the surgical approach, and the severity of the change requiring surgery. The connection between age and postoperative complications is principally explained by previous internal disease. Patients with malignant tumors are at greater risk than women with benign genital changes. Carcinoma cases apart, these patients are older and have suffered more from previous internal disease. While postoperative morbidity and mortality rates are higher among older patients, the percentage of complications occurring is so low that age does not represent a contraindication to gynecological surgery.

Adolescent↗

Adjuvant radiotherapy in the surgical treatment of the carcinoma of the cervix.

Treatment results of 1,092 patients with operated cervical cancer, covered by a cooperative program including the Departments of Obstetrics and Gynecology of four universities, were analysed. Standardized surgical procedures and histological processing of the surgical specimens were employed throughout. The indication to postoperative radiotherapy was different in the different university departments. In order to carry out a realistic comparison of the achieved treatment results, not the clinical staging, but the tumour extension histologically determined on the surgical specimen, was taken into account. In cases presenting a continuous tumour growth corresponding to histological Stage Ib, the 5-year-survival rates achieved were 90.5% and 95.6% for patients only operated, or operated and subjected to radiation therapy, respectively. In cases of continuous tumour growth corresponding to histological Stage II, the 5-year-survival rates were 79.5% following surgery only, and 83.1% after surgery and radiation. The differences between the corresponding survival rates were not statistically significant. The further proof of tumour parameters and the formation of twin pairs, revealed that the prognosis of patients presenting unfavourable tumour criteria could not be influenced by a postoperative radiation therapy.

Carcinoma, Squamous Cell↗

What's new in prognosis of uterine cancer?

Prognosis represents an attempt of prediction of a future evolution, based on the critical judgement of a present status. A prognosis may have a qualitative as well as a quantitative character. The qualitative evaluation considers whether the course of a disease is modified, which means, whether it is influenced in a favourable or a disadvantageous way. In case of a quantitative statement, healing or absence of symptoms are taken as definitive criteria. It is our aim to analyse the prognostic significance of different criteria in patients with carcinoma of the uterus.

Adenocarcinoma↗

[Surgical treatment of cervix cancer. Treatment results and data on the postoperative course over a minimum of 5 years following uniform surgery and standardized histological examination of the histological material of 1092 patients at 4 university gynecology clinics].

Treatment results of 1092 patients with operated cervical carcinoma were evaluated and assessed on the basis of data supplied by four University Clinics of gynaecology. Surgical treatment and histological processing of all surgical specimens were uniform. Indication for postoperative radiation was determined differently at the individual clinics. The treatment results obtained can be compared with one another not on the basis of clinical stage assessment; the only criterion is the histologically proven extension of the tumour, ascertained via an examination of the surgically obtained specimen. With continuous tumour growth in accordance with stage Ib, the 5-year survival rate after surgery alone was 90.5%, after additional radiation 95.6%. In case of continuous tumour growth in accordance with stage II, the 5-year survival rate after operation alone was 79.5%, after operation and radiation 83.1%. The differences in the 5-year survival rates are statistically not significant. Taking into consideration a discontinuous metastatic tumour growth in the region of the parametric tissue, the 5-year survival rate after operation alone was 72.7%, after subsequent radiation 75%, in case of metastases in the region of the lymph nodes 77.8% and 60.5%, respectively. These differences in survival rates were not statistically verifiable. Furthermore, if individual tumour parameters were tested and statistical pairing was performed, it became evident that prognosis of patients with infaust tumour criteria could not be influenced by postoperative radiation.

Combined Modality Therapy↗

Prognostic criteria in patients with endometrial cancer.

Between 1970 and 1977 216 patients were operated on for adenocarcinoma of the endometrium at the I. Universitäts-Frauenklinik, Munich. The 5-year-survival rate for stage Ia was 79.7%, for stage Ib 86.4%, and for stage II 66.7%. Reliable prognostic criteria were tumor grading, lymphatic invasion, and myometrial tumor invasion. The 5-year-survival rate in patients with grade 1 carcinoma was 88.9% in patients with grade 3 carcinoma only 33.3% Patients with adenoacanthoma had a 5-year-survival rate of 73.3%, those with an adenosquamous carcinoma a 5-year-survival rate of 50%. Patients with no evidence of lymphatic invasion showed a 5-year-survival rate of 84.9%, those with proven invasion of lymphatic vessels a survival rate of 52.9%. In patients with tumor infiltrating one third of the myometrium the 5-year-survival rate was 90%. In patients with tumor infiltrating two thirds of the myometrium the 5-year-survival rate was 66.7%, and with infiltration of the full thickness of myometrium it was 33.3%.

Adenocarcinoma↗

[Morphological criteria in decreased patients who had undergone surgery for cervical cancer].

In 966 patients who had undergone surgery and who had been suffering from squamous cell carcinoma, tumour recurrence occurred in 16.8% of the cases. In almost 70% of these cases, recurrence was seen in the first two years following treatment. 15% of the patients died of the carcinoma. Compared with the patients who had stayed alive, post-mortem examination of the patients who had died of carcinoma revealed in 65.5% of the patients an immature squamous cell carcinoma, in 37.7% a dissociated tumour growth, in 21.7% penetration of the tumour into the lymph vessels, and in 62.1% penetration into the blood vessels. Macrometastases in the area of the regional lymphatic nodes were seen in 45.2%. In the surviving patients, the percentage of immature carcinomas was 47.4%, whereas dissociated tumour growth was seen in 18.7% and penetration into the lymph or blood vessels in 5.8 and 14.1% of the cases, respectively. Macrometastases in the area of the regional lymphatic nodes were seen in 11.8% of the cases. In woman patients with an early recurrence of tumour, or in women who had died of the carcinoma, mostly immature carcinomas, tumour penetration into vessels, and macrometastases in regional lymphatic nodes were observed.

Carcinoma, Squamous Cell↗

[The prognostic importance of the stage in patients operated for carcinoma of the endometrium (author's transl)].

The operative specimens of 216 patients who underwent operation for adenocarcinoma of the endometrium stage I and stage II were thoroughly examined. It was found that measuring the maximal depth of infiltration of the carcinoma in relation to the thickness of the uterine wall and other morphological criteria of the tumours such as tumour grading, and carcinomatous lymphangiosis have greater prognostic value than clinical staging and the length of the uterine cavity to the sound. In contradistinction to other observations we found that patients with a short length of the uterus had more often recurrences and distant metastases than patients with a long uterine length to the sound.

Adenocarcinoma↗

[Gynaecological problems in women patients on dialysis treatment and in women following renal transplants (author's transl)].

Women patients on permanent dialysis treatment or after transplants display on the whole an increased rate of malignomas; however, it has so far not been possible to assess the relevant incidence in a uniform manner. Hence, regular gynaecological examination should be the rule in order to detect and treat carcinoma risk changes in the genital region. Within the framework of a special gynaecological consultation for renal patients we found in 81 women patients under dialysis treatment one patient with carcinoma of the cervix and one patient with corpus carcinoma. In two cases a cystic ovarial tumour was operated on. To date the 21 patients who had undergone renal transplant surgery did not show any malignant change in the genital region. Choice of contraceptives should rule out the intrauterine device because of the increased hazard of infection under immunosuppressive treatment. Ovulation inhibitors with higher oestrogen doses represent an additional hypertensive risk. Treatment with low-dosage gestagens should produce the lowest rate of side effects.

Adolescent↗

[Assessment of prognostic criteria in uterine carcinomas (author's transl)].

Prognostic criteria of cervical and uterine carcinomas can be important for both physician and patient. Compared with patients not subjected to surgical treatment, a multitude of prognostic criteria must be investigated in operated women via the systemic examination of the surgical specimen, reaching beyond the weight attached to the clinically assumed staging. These criteria enable quantitative and qualitative characterization of the carcinomas allowing individualisation of therapy adapted to the tumour.

Carcinoembryonic Antigen↗