[Possibilities and trends in the comprehensive treatment of malignant ovarian epithelial tumors].
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Biomedical subjects
Publications and source records attributed to L Rob.
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The incidence of all malignant tumours of the female reproductive organs in our country is on average by 40% higher than the worldwide incidence and with the exception of carcinoma of the uterine cervix it is still slowly rising. Gynaecological oncology emphasizes: prevention with accurate classification of premalignant changes to ensure adequate treatment; radical surgery primarily in invasive forms as well as with regard to staging as a prerequisite for indication of adjuvant treatment; interdisciplinary team cooperation which indicates without time losses all therapeutic steps, incl. inoperable tumours, and ensures permanent follow-up.
The authors reviewed the subsequent pregnancy experience in patients with malignant gestational trophoblastic disease who were managed at the Czechoslovak Trophoblastic Disease Center between January 1981 to December 1990. Thirty-five women who conceived following successful chemotherapy of gestational trophoblastic disease subsequently became pregnant a total of 53 times. Twenty-seven of these 53 pregnancies or 51% terminated in live-born infants. Major or minor congenital malformations were not detected. Those subsequent pregnancies concluded in 23 full-term deliveries (85%) and 4 premature births (15%). Primary cesarean section was performed for 5 (19%) women. Three or 6% ended in spontaneous abortion, one or 2% ended in mola hydatidosa partialis and mola hydatidosa completa. Sixteen pregnancies or 30% terminated in therapeutic abortion. Five women or 9% are now pregnant. Those patients who are treated successfully with chemotherapy should be reassured that they can anticipate a normal reproductive outcome in later conceptions.
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One hundred and twenty-three female patients were subjected to ultrasound and CT examinations on account of suspected tumours in the area of the lesser pelvis, or to evaluate the postoperative situation. Twenty-five patients were subjected in addition to the mentioned examinations also to angiography of the pelvic arteries. From comparison of the results of the radiodiagnostic examination and the surgical (histological) diagnosis ensues that in patients with a malignant tumour of the ovaries and uterus and with a benign tumour of the uterus the CT examination gives-more satisfactory results than the ultrasound examination. In patients with a benign tumour of the ovaries ultrasonic and CT examinations were approximately equally satisfactory.
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Revision of 630 cases of mola enabled a description of morphology in complete hydatid mole, partial hydatid mole, hydropic degeneration and their relation to the origin of trophoblastic disease. A survey covers pathogenesis of molar syndrome, cytogenetic findings and genetic methods for discrimination of complete and partial hydatid mole. To express grade of certainty in diagnostic of the lesions is recommended.
The authors list units of trophoblastic disease and its classification used and elaborated in the Centre for trophoblastic disease. The authors submit detailed information on the organization of diagnostic and therapeutic and preventive care of patients with trophoblastic disease in the CSSR. The authors draw attention to the establishment of a Centre for trophoblastic diseases (CTN) with the statute of a reference department. Reasons for its legalization are given. Its function and structure are described.
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