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Biomedical subjects

J Menczer

Publications and source records attributed to J Menczer.

At least 55 records · Page 3Linked to original sources
PubMed1995

Surgical vs. clinical staging of endometrial carcinoma. The impact on treatment modification, morbidity and survival.

OBJECTIVE: To assess the impact of surgical staging on treatment modification and outcome in endometrial carcinoma (EC) patients. METHODS: Two groups of histologically confirmed clinical Stage I and II EC patients, diagnosed during two time periods (1976-1984 and 1985-1991), were retrospectively compared. Sixty-five patients diagnosed during the first period were staged only clinically and treated according to a protocol based on this staging system. Fifty-six patients diagnosed during the second period were staged surgically and treatment was modified according to surgical pathological findings. RESULTS: The findings based on the surgical staging spared radiotherapy in some patients and prompted additional treatment in others. The morbidity and survival were similar in the two groups. CONCLUSIONS: Surgical pathological findings in EC patients may modify management and contribute to prognostic significance. No effect on postoperative morbidity or on actuarial survival was demonstrated.

Adult↗
PubMed1994

Outpatient endometrial sampling with the Pipelle curette.

This study compares outpatient endometrial sampling using the Pipelle endometrial sampling curette with conventional dilation and curettage (D&C) in patients with abnormal uterine bleeding. Endometrial sampling with the Pipelle curette was performed in 172 and D&C in 97 women. No complications were encountered with either of these procedures. One hundred and seventy (98.8%) of the Pipelle aspirations attempted were successfully completed. Sufficient material for histological assessment was obtained in 154 (90.6%) of the women who underwent Pipelle endometrial sampling and in only 66 (68%) of those who underwent D&C (p < 0.0001). In postmenopausal women, adequate specimens were obtained in 74 of 88 (84.1%) by Pipelle and in only 22 of 48 (45.8%) by D&C. In 45 cases the histologic diagnosis of the endometrium obtained by Pipelle sampling was compared with the one of endometrium obtained by D&C or hysterectomy performed shortly thereafter. The diagnosis was identical in 43 (95.5%) cases. Endometrial sampling with the Pipelle was well tolerated causing occasionally only slight discomfort.

Ambulatory Surgical Procedures↗
PubMed1994

Insulin-like growth factor-I (IGF-I) and IGF-binding protein-2 are increased in cyst fluids of epithelial ovarian cancer.

Expression of insulin-like growth factor-I (IGF-I), its receptor, and IGF-binding proteins (IGFBPs) by epithelial ovarian cancer cells and its mitogenic effect on these cells in vitro suggest that IGF-I may have a role in the regulation of human ovarian cancer. To examine this role in vivo, we explored the IGF-I/IGFBP system in sera and cyst fluids of women undergoing surgery for simple and other benign cysts (n = 20) and borderline (n = 5) and invasive malignant epithelial neoplasms (n = 11). The IGF-I level was significantly higher in cyst fluid from invasive malignant compared to cyst fluid in benign neoplasms (16.1 +/- 2.2 vs. 7.3 +/- 1.2 nmol/L; P = 0.002). Although benign cysts contained almost no IGFBP, high IGFBP-2 levels were detected in malignant cysts regardless of histological type. Serum IGFBP-2 levels were also higher in women with invasive malignancy than in benign controls (1.32 +/- 0.32 vs. 0.53 +/- 0.07 relative units; P = 0.004). IGFBP-2 was higher in cyst fluids than in the corresponding sera, implying local production of this protein. Estradiol was high in fluid from invasive malignant cysts of postmenopausal women and correlated with IGF-I in the cyst fluid. Levels of IGF-I, IGFBP-2, and estradiol in cyst fluid could discriminate between benign and malignant neoplasms, except for the endometrioid-type tumors (n = 2). Our data support a role for IGF-I in the proliferation of ovarian cancer and suggest that IGF-I and estradiol interact in regulating this malignancy.

Adult↗
PubMed1994

Intraperitoneal cisplatin chemotherapy versus abdominopelvic irradiation in ovarian carcinoma patients after second look laparotomy. A reassessment based on mature data.

In a previously published study we compared the outcome probability within 3 years after diagnosis in two groups of advanced ovarian carcinoma patients in complete clinical remission with minimal or no residual disease at second look laparotomy, performed after completion of cisplatin based combination chemotherapy. One group (n = 18) received after reexploration, abdominopelvic irradiation (RT group), the other diagnosed during a later period (n = 19), received after reexploration three courses of introperitoneal cisplatin chemotherapy with systemic thiosulfate protection (IP) group). In the present study the outcome of the same patients is compared after they have all been followed for at least 5 years or till death. A clear trend towards a more favorable, through statistically not significant, 5 year survival was observed (68%), in the IP group, vs 39% in the RT group (p = 0.07). In patients with a negative second-look laparotomy, the respective 5 year survival rates were 92% and 60% (p = 0.08). While the duration of the progression-free interval was similar in both treatment groups the survival after diagnosis of recurrence was significantly better in the IP group (41% vs 0%, p = 0.03).

Abdomen↗
PubMed1994

Laparoscopic prophylactic oophorectomy in women belonging to ovarian cancer-prone families. Advantages and shortcomings.

Laparoscopic prophylactic oophorectomy was performed on four women who belonged to ovarian cancer prone families. The procedure was of short duration with an uncomplicated intra- and postoperative course and required only brief hospitalization. These merits may outweigh those of prophylactic oophorectomy performed by laparotomy during which hysterectomy is usually also performed. When prophylactic oophorectomy is contemplated, operative laparoscopy should also be considered.

Adult↗
PubMed1993

Impaired binding properties of endothelin-1 receptors in human endometrial carcinoma tissue.

BACKGROUND: Endothelins, potent stimulators of smooth muscle tissue activity, were recently shown to also function as mitogens for numerous cell types. The authors investigated the properties of endothelin-1 (ET-1) receptors in human endometrial tissue compared with human endometrial carcinoma tissue. METHODS: Tissue samples from 13 patients with endometrial carcinoma and from 12 women undergoing hysterectomy due to uterus myomatous were obtained immediately after surgical removal. Binding properties of the endothelin receptors were studied using 125I-labeled ET-1. RESULTS: A significant difference was demonstrated between binding properties of ET-1 receptors of these two groups. The mean maximal density (Bmax) value of the normal endometrial samples was 2029 +/- 341 fmol/mg protein, whereas that of the neoplastic samples was 356 +/- 121 fmol/mg protein. No differences were found, however, between the mean dissociation constant (Kd) values of these groups. CONCLUSIONS: These results might be compatible with the increased blood flow that characterizes malignant endometrial tissue. However, they do not indicate an important mitogenic role for ET-1 in the development of endometrial cancer.

Adult↗
PubMed1993

Cytologic examination of ovarian cyst fluid for the distinction between benign and malignant tumors.

OBJECTIVE: To assess the feasibility of using cytologic examination of ovarian cyst fluid for distinguishing between benign and malignant tumors. METHODS: Cyst fluid was aspirated at surgery in 83 women with benign and 35 women with malignant (25 invasive and ten borderline) ovarian tumors and submitted for routine cytologic examination. RESULTS: The specificity of the cytologic examination was 100%, but the sensitivity and negative predictive value were only 26 and 76%, respectively. CONCLUSION: The low sensitivity and negative predictive value of cytologic cyst fluid examination preclude its use for the distinction between benign and malignant ovarian tumors.

Adolescent↗
PubMed1993

Cyst fluid CA 125 levels in ovarian epithelial neoplasms.

OBJECTIVE: To assess the feasibility of using cyst fluid CA 125 levels to distinguish between benign and malignant ovarian cystic neoplasms. METHODS: CA 125 levels were measured in ovarian cyst fluid and in serum obtained at surgery in 44 women with ovarian cystic tumors of epithelial origin (25 benign, 12 malignant, and seven borderline). RESULTS: The median cyst fluid CA 125 level in malignant neoplasms (671 U/mL) was higher than in benign tumors (175 U/mL), and 86% of the malignant tumors contained levels higher than 100 U/mL in the cyst fluid, compared with only 62% of the benign tumors. However, these differences were not statistically significant. CONCLUSION: Cyst fluid levels of CA 125 cannot be used to distinguish between benign and malignant ovarian cysts of epithelial origin.

Adolescent↗
PubMed1992

Intraperitoneal chemotherapy versus no treatment in patients with ovarian carcinoma who are in complete clinical remission.

BACKGROUND: The optimal management of patients with ovarian carcinoma who are in complete clinical remission after completion of postoperative cisplatin-based chemotherapy has not been established. METHODS: In this study, the outcomes of two groups of such patients were compared. One group of 25 patients underwent a second-look laparotomy and subsequently received three courses of intraperitoneal chemotherapy (IP group). The other group of 12 patients was not reexplored and received no additional treatment (NT group). RESULTS: A trend for better survival in the IP group was found compared with the NT group. There was no difference in the duration of the progression-free interval. CONCLUSIONS: More effective treatment for the consolidation of complete clinical remission in patients with ovarian carcinoma is needed.

Aged↗
PubMed1992

Intraperitoneal cisplatin chemotherapy in ovarian carcinoma patients who are clinically in complete remission.

Three courses of intraperitoneal cisplatin chemotherapy with systemic thiosulfate protection were administered to 31 stage II-IV ovarian carcinoma patients who were clinically in complete remission after completion of postoperative cisplatin-based combination chemotherapy. The 5-year survival rate was 60.4% and the median progression-free interval 35 months. Among 25 patients who underwent second-look laparotomy, the survival and the duration of the progression-free interval were significantly better in those with a pathologically confirmed complete response. Short-term intraperitoneal cisplatin chemotherapy should be considered for consolidation of treatment in ovarian carcinoma patients who are clinically in complete remission.

Adult↗
PubMed1992

Recurrence rate after fluid aspiration from sonographically benign-appearing ovarian cysts.

The outcome after fluid aspiration from 41 sonographically benign-appearing ovarian cysts was assessed. The considerable probability of recurrence was significantly higher after ultrasound-guided aspiration than following aspiration via laparoscopy (54% versus 30%, respectively, at 36 months). Although all the recurring cysts were benign, the concern with malignancy and the high recurrence rate seem to indicate that fluid aspiration from sonographically benign-appearing cysts by either method is not the management of choice.

Adolescent↗
PubMed1992

Cisplatin in combination with continuous VP16 infusion as second line chemotherapy in ovarian carcinoma. A pilot study.

Effective second line chemotherapy schedules for recurrent ovarian carcinoma are not available. The combination of cisplatin and VP-16 given as a single dose in such patients gave inconsistent results. Since VP-16 is a dose-schedule dependent drug it was given in this pilot study as a continuous 72 hour infusion at a dose of 100 mg/m2/day. No objective response was observed among 7 patients with refractory or recurrent ovarian carcinoma who received a median of 3 treatment courses.

Adenocarcinoma↗
PubMed1992

Cytoreductive surgery in the treatment of advanced ovarian carcinoma. Some controversial aspects.

Primary cytoreductive surgery in the treatment of advanced ovarian carcinoma is widely accepted and practiced. Its value has however never been established by controlled trials and the concept is therefore not unchallenged. Data with regard to the benefit of interval and secondary debulking are limited and often conflicting. Prospective randomized studies specifically designed to elucidate the controversies relevant to cytoreductive surgery are warranted.

Carcinoma↗
PubMed1991

Downregulation of specific protein carboxylmethyltransferase immunoreactivity in human endometrial carcinoma.

Protein carboxylmethyltransferases (PCMT), enzymes that methylate free carboxyl groups of proteins, are involved in functional modification of various proteins including those of age-damaged proteins and the oncogenic ras proteins. Several species of PCMT are associated with these modifications. By using western blot analysis and specific antibodies raised against one type of PCMT, a 30-kilodalton (KD) cytosolic enzyme from Torpedo electric organ was identified in human erythrocytes and endometrium. The high specificity of the antibodies made it possible to compare levels of immunoreactive 30-KD PCMT protein in normal human endometria and endometrial carcinomas. Assays done on samples from 23 patients indicated the average levels of immunoreactive 30-KD PCMT in endometrial carcinomas was one fifth that of normal endometrium. The sensitivity of the assay was 83%, and its specificity was 90%. These results suggest that levels and activity of the 30-KD PCMT may be downregulated to maintain the phenotypic expression of the endometrial carcinoma. These assays may be used to assist in the detection of endometrial carcinomas.

Adult↗