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Biomedical subjects

J Bellmunt

Publications and source records attributed to J Bellmunt.

68 records · Page 4Linked to original sources
PubMed1990

Ifosfamide + mitoxantrone in advanced breast cancer previously treated with anthracyclines.

We treated 19 patients previously exposed to anthracyclines (progression during therapy or after discontinuation of therapy) with ifosfamide (IFO) 2 g/m2 i.v. in a 1-h infusion daily for 3 days with mesna uroprotection and mitoxantrone (MZT) 12 mg/m2 on day 1 of every 3-week cycle. The response rate was assessed after two cycles. A response to treatment was observed in 6 of 15 evaluable patients (40%), with no complete remission and 6 partial remissions. The median duration of response was 6+ months (3+ to 12+). The toxicity was acceptable, with three episodes of grade 3-4 myelosuppression (8%) and one case of congestive heart failure resulting from a fluid overload that responded to medical treatment. The IFO-MZT combination is an effective second-line regimen in advanced breast cancer previously treated with anthracyclines.

Adult↗
PubMed1989

Fatal septic thrombophlebitis due to Salmonella enteritidis.

The case is reported of a patient with gastric adenocarcinoma with metastases who developed a septic focus in a saphenous vein. Salmonella enteritidis was cultured from blood, sputum and stool specimens, and from a thrombus removed from a varicosity of the saphenous vein. Extraintestinal infections caused by non-typhoid salmonella usually afflict debilitated and immunocompromised patients. Metastatic septic foci may appear anywhere in the organism, including the vascular system, but involvement of the venous system has not previously been reported.

Adenocarcinoma↗
PubMed1989

Orbital metastasis, by transitional cell carcinoma of the bladder.

We report a new case of a patient with transitional cell carcinoma of the urinary bladder and a solitary metastasis to the orbita. A review of the literature shows two cases described previously. This case is interesting for the clinical features and evolution.

Carcinoma, Transitional Cell↗
PubMed1989

Mitomycin-C and vinblastine in advanced breast cancer.

Forty-two patients with metastatic breast cancer refractory to first-line therapies were treated with combination chemotherapy with mitomycin-C and vinblastine. A response to treatment was observed in 11 of 34 evaluable patients (32.3%), with 3 complete remissions (8.8%) and 8 partial remissions (23.5%). The median duration of response was 185+ days. The 12-month survival was 78% for responders, 48% for patients with stable disease and 0% for patients with progressive disease. The toxicity was acceptable with 20 episodes of moderate myelosuppression (58.8%) and 2 cases with congestive heart failure that responded to medical treatment. The MMC-VBL combination is an active regime for advanced breast cancer previously treated with antracyclines. This combination may be regarded as a standard second-line treatment for this type of tumor.

Adult↗
PubMed1989

Epithelioid hemangioendothelioma of the liver with myocardial metastases.

Epithelioid hemangioendothelioma is an unusual type of endothelial-derived vascular tumor located mainly in the soft tissues of the limbs. The present report describes a 48-year-old woman with an epithelioid hemangioendothelioma located in the liver with very unusual metastases to the myocardium. While the disease itself was controlled by adriamycin the patient died as a consequence of portal hypertension due to the abundant fibrotic component distinctive of this type of tumor. An epithelioid appearance can sometimes lead to a mistaken diagnosis of metastatic carcinoma, as happened initially in our case. The endothelial origin of the tumor must be confirmed by electron microscope identification of Weibel-Palade bodies or by immunohistochemical staining of factor VIII-related antigen. To the authors knowledge, this is the first case of myocardial metastases from an epithelioid hemangioendothelioma of the liver to be reported in English in the medical literature.

Female↗
PubMed1988

Palmar-plantar erythrodysesthesia syndrome associated with short-term continuous infusion (5 days) of 5-fluorouracil.

A case of palmar-plantar erythrodysesthesia syndrome (PPES) observed during a 120-h infusion of 5-fluorouracil (5-FU) is presented. This syndrome has been described in the literature after protracted infusion chemotherapy of over 30 days. The agent most frequently associated with this syndrome was 5-FU. A 53-year-old man was admitted to the hospital with a well-differentiated squamous cell carcinoma of the retromolar trigone. The patient received 100 mg/m2 of cisplatin on day 1 and 120-h continuous infusion of 1000 mg/m2 of 5-FU every 3 weeks. After the second course, the patient developed clinical features consistent with PPES. This side effect has not been previously reported with short-term (5-day or 120-h) continuous infusion of 5-FU. Less frequently, the syndrome has also been described with 10-day continuous infusion. The etiopathogenesis of PPES is unclear, but it seems to be dose-dependent and probably related to cutaneous drug accumulation.

Carcinoma, Squamous Cell↗
PubMed1988

Wilms' tumor in an adult patient.

We present herewith a case of Wilms' tumor in an adult patient. He underwent radical surgery, chemotherapy (adriamycin, actinomycin, vincristine and cyclophosphamide) and radiotherapy. He is alive and free of disease after 48 months of follow-up.

Adult↗
PubMedDate not supplied

Early results of the value of p53 in predicting survival in a homogeneous cohort of patients with invasive bladder cancer treated with a neoadjuvant carboplatin-based regimen (M-CAVI).

AIMS AND BACKGROUND: Several reports on prognostic factors for infiltrating-bladder cancer have given controversial results. We assessed the prognostic value of p53 nuclear overexpression together with known prognostic factors for survival in patients with invasive T2-4 N0 M0 bladder cancer treated with neoadjuvant chemotherapy. STUDY DESIGN: Thirty-five paraffinized tumor samples from initial transurethral resection of patients with bladder cancer were analyzed immunohistochemically to detect overexpression of p53 protein. Patients were treated with 3 to 4 cycles of neoadjuvant methotrexate, carboplatin, and vinblastine (M-CAVI) and then underwent radical cystectomy. Prechemotherapy, treatment, and postchemotherapy factors were analyzed for correlation with survival by univariate and multivariate analysis. Fifty-seven percent of tumors were positive for p53 protein, 71.5% had grade III-IV tumors, and 72% had organ-confined disease. The median follow-up was 20 months (range 5-71+). RESULTS: By univariate analysis, the significant pretreatment factors were initial tumor (T) stage (P < 0.0001) and the male sex (P = 0.03). Five postchemotherapy variables were found significant: surgery performed according to protocol (P = 0.003), overall clinical (P = 0.004), and overall pathologic (P = 0.02) response to therapy, postchemotherapy pathologic stage (P = 0.0002), and tumor status after surgery (P = 0.0006). By multivariate analysis, the initial prechemotherapy T stage was the only factor that demonstrated independent significance. CONCLUSIONS: Although the median follow-up of the study is still too short, in this group of patients treated with a neoadjuvant carboplatin-based regimen, a classical variable (prechemotherapy T stage) rather than p53 nuclear overexpression was an independent prognostic factor for survival. Further follow-up will be required to assess the value of p53 overexpression as a prognostic factor in invasive bladder cancer patients treated with neoadjuvant carboplatin-based chemotherapy.

Aged↗
PubMedDate not supplied

Node-negative breast cancers with p53(-)/HER2-neu(-) status may identify women with very good prognosis.

BACKGROUND: The contribution of p53 and HER-2/neu to the management of node-negative breast cancer (NNBC) could be improved by combining their results. MATERIAL AND METHODS: We studied paraffin-embedded primary tumors for p53 (BP-53-12-1) (n=57) and HER2/neu (pAB1) (n=63) from NNBC patients. The results were grouped in a negative (p53(-)/neu(-)) versus a positive group (one or both overexpressed). The association between both groups (negative and positive) and clinicopathologic parameters, S-phase fraction and DNA ploidy, and patients' outcome, was analyzed. RESULTS: In 28% of the tumors p53 was overexpressed, and HER2/neu in 11%. Sixty-five percent (37 out of 57) were p53(-)/neu(-), and 35% overexpressed one (31.5%) or both (3.5%) oncoproteins. Significant correlations were found between p53(-)/neu(-) tumors and age greater than 50 (p=0.003), S-phase fraction lower than 7 (p=0.03), and positive estrogen receptor contents (p=0.049). Actuarial 5-year disease-free and overall survival for p53(-)/neu(-) tumors were 88% and 97%, respectively, versus 50% and 66%, for tumors overexpressing one or both oncoproteins (p=0.004).

Age Factors↗
PubMedDate not supplied

p53 oncoprotein as a prognostic indicator in patients with breast cancer.

UNLABELLED: p53 is a tumor suppressor gene located on the human chromosome 17 that is thought to regulate (suppress) the proliferation of normal cells. The mutant protein accumulates in the nuclei of tumor cells that may then have a proliferative advantage over normal cells. The purpose of this study was to investigate the relationship between levels of mutant p53 expression and the clinical outcome of patients with node-positive and node-negative breast cancer. Expression of mutant p53 was evaluated in 655 human breast carcinomas (349 node-positive and 306 node-negative patients) with long-term clinical follow-up by immunohistochemistry in sections from paraffin embedded tumors. RESULTS: Immunoreactivity was found in 37.3% of breast tumors. There was no significant correlation between the expression of p53 and tumor size, nodal involvement, age or histological type. However, p53 overexpression was clearly related to histological grade and steroid receptors, with a trend to higher overexpression in ER-tumors or in those with a high histological grade (p < 0.01). On univariate analysis positive tumors were associated with reduced DFS in the total group (p < 0.001) as well as in node-positive patients (p < 0.05) and in node-negative patients (p < 0.01). In conclusion, these results suggest that the immunoreactivity of p53 may be a biologic marker of prognostic significance in both node-positive and node-negative patients.

Biomarkers, Tumor↗