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K Dehaeck

Publications and source records attributed to K Dehaeck.

At least 19 recordsLinked to original sources
PubMed1996

Acetic acid visualization of the cervix: an alternative to cytologic screening.

OBJECTIVE: To investigate the value of acetic acid visualization of the cervix as an alternative to cytologic screening. METHODS: A prospective study was conducted in a squatter area in Cape Town, South Africa, on 2426 women who underwent speculum examination, naked-eye inspection of the cervix after application of acetic acid, and cytologic smear. The smears were stained and processed at the screening site. Patients with a positive reading after acetic acid or a smear indicating a high-grade squamous intraepithelial lesion (SIL) were referred for immediate colposcopy, biopsy, and when indicated, treatment by large loop excision of the transformation zone. Therefore, histology was obtained on all patients with a positive acetic acid test or a positive cytology. RESULTS: Seventy-six women with positive reactions to acetic acid. Among the 2350 women with negative reactions, 254 had positive cervical smears; only 11 of these had histologic high-grade SIL. In contrast, 20 of the 61 women with positive cytology and positive acetic acid test had high-grade SIL on histology. Therefore, the acetic acid reaction enabled the observer to detect 20 of the 31 women (64%) who exhibited a high-grade SIL both on cytology and histology. CONCLUSION: In locations where access to cytopathology is limited, naked-eye visualization of the cervix after application of diluted acetic acid warrants consideration as an alternative in the detection of cervical premalignant lesions.

Acetates↗
PubMed1996

The influence of hormonal status on excision margins after large loop excision of the transformation zone (LLETZ).

To evaluate the influence of the type of contraception used and post-menopausal status on the involvement of excision margins with CIN after Large Loop Excision of the Transformation Zone (LLETZ), the authors reviewed a computerised database and the clinical files of 451 sequential women treated by LLETZ, for CIN diagnosed on cytology and colposcopy. There was a statistically significant association between both the use of Long Acting Injectable Progesterone (LAIP) and post menopausal status with histological report of incomplete excision of CIN on the endocervical excision margin. Therefore, the authors conclude that both progesterone-only containing contraception and menopause induced atrophy of the endocervical epithelium significantly increase the risk of involvement of the endocervical excision margin with CIN in the treatment by LLETZ. This parameter is of particular importance, as it is one of the known factors for recurrence.

Contraception↗
PubMed1995

Placental site trophoblastic tumor: three case reports and literature review.

The clinical features of three patients with placental site trophoblastic tumour (PSTT) are presented. Two patients had probable nephrotic syndrome, which was unrecognized at the time. The nephrotic syndrome disappeared after hysterectomy in one patient and the other demised after one cycle of chemotherapy. The use of hysteroscopy in one patient and the management of a pulmonary metastasis in another are described.

Adult↗
PubMed1995

Cervical carcinoma associated with pregnancy.

Because of the uncommon synchronous occurrence of pregnancy and invasive cervical carcinoma, this disease entity remains poorly understood. In addition inconsistent reporting has precluded meaningful meta-analysis. About 1 in 2000 pregnancies are associated with cervical cancer and pregnancy is a complication in approximately 3 percent of patients with cervical cancer. There is little evidence to suggest that the pregnancy has an influence on prognosis. Although not firmly established, vaginal delivery may have an adverse effect on outcome. Timing of delivery must be individualized inasmuch as there is a role for delaying treatment in order to achieve fetal lung maturity. Surgery and radiotherapy should be utilized in the same stage-dependent manner as in nonpregnant patients but management should be individualized and undertaken by a multidisciplinary team. These and other issues are discussed more fully in this review.

Adult↗
PubMed1995

Does colposcopically directed punch biopsy reduce the incidence of negative LLETZ?

OBJECTIVE: To evaluate the role of punch biopsy in reducing the occurrence of negative histology provided by large loop excision of the transformation zone in the management of cervical intraepithelial neoplasia. DESIGN: Retrospective review of computerised data base and clinic files. SETTING: Colposcopy Clinic, Groote Schuur Hospital, Cape Town, South Africa. SUBJECTS: Two hundred and ninety-eight women considered suitable for the local outpatient management of cervical intraepithelial neoplasia. METHODS: Two groups of patients were identified: group A consisted of women who had cervical intraepithelial neoplasia confirmed colposcopically and who underwent directed punch biopsy; group B consisted of women who had cervical intraepithelial neoplasia confirmed colposcopically and were referred for large loop excision of the transformation zone without confirmatory punch biopsy. RESULTS: In Group A (n = 184) 123 women had cervical intraepithelial neoplasia diagnosed on punch biopsy. Large loop excision of the transformation zone was performed on 116 women and 7 were lost to follow up. The procedure confirmed cervical intraepithelial neoplasia in 95 cases (82%), but there was no cervical intraepithelial neoplasia in 21 cases (18%). Sixty-one women had negative punch biopsies. Of these, 13 underwent large loop excision of the transformation zone, 31 had persistently negative follow up cytology, and 9 had positive cervical smears of which 7 were treated with large loop excision of the transformation zone, and 8 were lost to follow up. Overall, 25% of all negative punch biopsies were falsely negative. In group B 114 were treated with large loop excision of the transformation zone and cervical intraepithelial neoplasia was confirmed in 97 cases (85%); one woman had unsuspected microinvasion (1%) and 16 women (14%) had no cervical intraepithelial neoplasia. Negative histology after large loop excision of the transformation zone was not statistically different in groups A and B. CONCLUSION: Punch biopsy does not reduce the occurrence of negative histology after large loop excision of the transformation zone.

Adult↗
PubMed1995

Primary chemotherapy with bleomycin, ifosfamide and cisplatinum (BIP) followed by radiotherapy in the treatment of advanced cervical cancer. A pilot study.

Bleomycin, Ifosfamide and Cisplatinum were combined in a 3 cycle regime of neoadjuvant chemotherapy given prior to radiotherapy in the treatment of 26 patients with late Stage (FIGO IIB-IIIB) cervical cancer. Seven patients were withdrawn for reasons of compliance and 1 patient due to toxicity. The response rate to chemotherapy in the remainder (18 patients) was 44.4%. Sixtyfour per cent of 17 patients who completed chemoradiotherapy responded completely. This regime was generally well tolerated and neurotoxicity was less problematic than in other reports, although fatal pneumotoxicity occurred in one patient. It is too early to comment on survival; this is an interim report of responses and toxicities. The results are less impressive than in other reported studies and cast doubt on the role of neoadjuvant chemotherapy in the management of advanced cervical cancer in developing countries.

Adult↗
PubMed1992

The natural history of carcinoma of the cervix in young women.

Invasive carcinoma of the cervix was treated in 1,522 patients over a 10-year period at Groote Schuur Hospital. Data for each patient included place of residence, pathological characteristics of the tumour, nodal spread, histological evidence of human papillomavirus (HPV) infection, disease stage, treatment type, treatment complications, site of recurrence and survival time. Patients aged under 35 years comprised 11.6% of the total patient group. A retrospective cohort study compared women aged under 35 years of age at the time of entry into the study and women aged 35 years or more. In all, 82 eligible young patients were compared with random sample of 82 eligible older patients. Contingency tables, life tables and proportional hazards analysis were used where appropriate. There was no significant difference across the two age groups in the incidence of non-squamous tumours, or in the grades of squamous tumours. Similarly there was no evidence of differences in lymph node involvement or HPV infection. Young patients appeared to enter the study at significantly earlier stages of the disease, and a greater proportion of them underwent surgical treatment (diff = 36.4% +/- 13.5%). In both groups treatment complications were less frequently observed after surgery than after radiotherapy. Sites of tumour recurrence were similar in both groups, and there was no apparent difference in survival times.

Adenocarcinoma↗
PubMed1992

The influence of initial residual disease on the outcome of second-look laparotomy in patients with carcinoma of the ovary.

Sixty four patients with epithelial ovarian cancer underwent second-look laparotomy. Influencing factors on the outcome of the second-look laparotomy were analysed. Both grade and stage appeared to have an effect on the outcome of the procedure. However, this effect appeared to be dependent on the amount of residual disease after primary surgery. The amount of residual disease appeared to be independently associated with the outcome of second-look laparotomy.

Adult↗
PubMed1991

The value of magnetic resonance imaging in patients with carcinoma of the cervix (a pilot study).

Magnetic resonance imaging (MRI) was performed in 11 patients with untreated squamous carcinoma of the cervix. The MRI stage and clinical stage were both compared with the surgical stage. MRI stage was only accurate in three of the 11 patients (27.3%) while the clinical stage was correct in eight of the 11 cases (72.7%). MRI assessment of parametrial and lymph-node involvement was difficult to interpret. These preliminary findings suggest that MRI is not, at present, a useful adjunct to staging in the evaluation of patients with carcinoma of the cervix.

Adult↗