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L Wahlqvist

Publications and source records attributed to L Wahlqvist.

At least 19 recordsLinked to original sources
PubMed1990

Prognostic factors in clinical stage I nonseminomatous germ cell tumors of the testis: multivariate analysis of a prospective multicenter study. Swedish-Norwegian Testicular Cancer Group.

Between 1981 and 1986, 279 consecutive patients with clinical stage I (CS1) nonseminomatous germ cell tumors (NSGCT) of the testis underwent pathological staging (PS) with retroperitoneal lymphadenectomy (RPLND). Patients with retroperitoneal metastases (PS2) received adjuvant chemotherapy. The median follow-up time after RPLND was 50 months (range, 30 to 90). Clinical and histopathologic features were registered prospectively and analyzed for association with risk of having PS2, relapse despite pathological stage 1 (PS1) or the combined risk of either event, metastatic disease (MET). Seventy-five (26.9%) of the patients had PS2 disease, and 30 (14.7%) of the 204 PS1 patients relapsed, indicating that at least 105 (37.6%) of this CS1 population had subclinical MET at the time of orchiectomy. Four (1.4%) of the 279 CS1 patients died of testicular cancer. Multivariate analyses showed several variables to be significantly associated with outcome for the CS1 patients; vascular invasion in primary tumor and normal preorchiectomy serum alpha-fetoprotein (Pre-AFP) level indicated PS2 disease. If Pre-AFP was excluded from the model, the absence of teratoma or yolk sac elements in the primary tumor became significant predictors of PS2. Vascular invasion, absence of teratoma, and a short interval between orchiectomy and RPLND indicated increased risk of relapse in PS1 patients. Vascular invasion, normal Pre-AFP, absence of teratoma elements, and a short orchiectomy to RPLND interval were predictive of MET. Our results indicate that prognostic factors useful for stratification of CS1 patients with NSGCT to different treatment options may be established.

Chorionic Gonadotropin↗
PubMed1989

Carcinoma of the ureter: a clinicopathologic study of 49 cases.

We reviewed 49 patients with urothelial tumors of the ureter: 33 male and 16 female patients with a mean age of 64.8 and 66.3 years, respectively. Median followup was 83 months. Gross hematuria was present in 29 patients and a silent kidney was found in 21. The majority of the tumors were in the distal ureter and approximately 50 per cent of the patients had synchronous or asynchronous urothelial tumors. The majority of the patients had low grade, low stage tumors (75 per cent). A total of 21 patients underwent local resection and none died of tumor. Only 1 of these 21 patients had an ipsilateral recurrence. Nephroureterectomy was performed in 24 patients and 5 of them died of ureteral tumor, including 4 in whom periureteral tumor growth initially was recorded. The prognosis of patients with papillomas or grades 1 to 3, stages Pa to P1 ureteral tumors was excellent and a conservative approach is recommended for these patients. Abuse of combination analgesics containing phenacetin, phenazone and caffeine may be a risk factor for development of ureteral tumors.

Aged↗
PubMed1983

A prospective randomized study of preoperative irradiation with cystectomy or cystectomy alone for invasive bladder carcinoma.

Prognosis was studied in 44 patients with urothelial bladder tumors, WHO grades 2 or 3, invading the lamina propria or the muscular coat, without signs of distant metastases. The patients were preoperatively randomized into two groups according to treatment: total cystectomy with or without preoperative irradiation. The 3- and 5-year survival rates were 81 and 61%, respectively, in 22 patients not receiving preoperative irradiation. 22 patients preoperatively irradiated had 3- and 5-year survival rates of 81 and 75%, respectively. Individuals who were tumor-free at cystectomy after preoperative irradiation had an excellent prognosis and tumor eradication was achieved in 80% when a cumulative radiation effect (CRE) above 1,400 reu was administered. Only 1 of 10 patients who received a CRE above 1,400 reu died from bladder tumor. This might indicate that preoperative irradiation improves the survival rate providing the CRE exceeds 1,400 reu. The presence of residual tumor after transurethral resection, aimed at resecting the tumor completely, seems difficult to evaluate since the surgeon was mistaken in believing the excision to be radical in more than 50% of the cases. The risk of error was especially high when the tumor infiltrated the muscular wall of the bladder.

Adult↗
PubMed1982

Urine microscopy as screening method for bacteriuria.

Fresh urine samples from 90 ambulatory patients with urological disorders were examined for leucocytes by counting the number of WBC/mm3 and per high power field (HPF) in sediment. Bacteria could be cultured in 20 samples, 18 of which contained greater than 8 WBC/mm3. Two (3%) of the 63 samples with less than or equal to 8 WBC/mm3 contained bacteria. Bacteriuria was found in two (3%) of 65 samples containing 0--1 WBC/HPF. Microscopic examination of the sediment might be used for the screening of patients with a high frequency and urgency of micturition for bacteriuria. A normal number of urinary leucocytes (less than or equal to 8/mm3) indicates that no bacteria will be found in culture. Leucocyturia indicates a high probability of bacteriuria.

Adult↗
PubMed1982

Metastatic tumors to the kidney. A postmortem, radiologic and clinical investigation.

Metastatic neoplasms to the kidney were examined at postmortem in 26 patients and by clinical and radiologic methods in 7 patients. It is stated that clinical symptoms and radiologic signs of renal metastases will be found in advanced cases with large tumors, that modern surgical techniques will be of benefit in selected cases, and that angiography yields little information on the nature of the mass lesion but is important in cases of diagnosis and management of massive hematuria.

Adult↗
PubMed1982

Plasma proteins and anti-kidney antibodies in renal carcinoma.

Occurrence of the nephrotic syndrome in association with renal carcinoma has been reported earlier. There is a risk of masking of carcinoma due to symptoms of nephrotic syndrome/glomerulonephritis. In this study the serum protein profile in patients with renal carcinoma was found to be similar to that of patients with glomerulonephritis. However, increased levels of complement factors C3 and C4 were found, indicating low or none complement consumption. Patients with metastasis had higher blood ESR, orosomucoid, CRP, C3 and C4 but lower Hb and albumin than patients without evidence of metastasis. Immunofluorescence examination of kidneys and sera indicated the occurrence of antibodies against glomerular structures, IgG antibodies were demonstrated in most patients, IgA and IgM in some.

Aged↗
PubMed1979

A prognostic study of urothelial renal pelvic tumors: comparison between the prognosis of patients treated with intrafascial nephrectomy and perifascial nephroureterectomy.

A comparison of the prognosis between 2 series of patients with urothelial renal pelvic tumors is presented. One series comprising 70 patients was operated with intrafascial nephrectomy with extirpation of varying length of the ureter. The other series comprising 38 patients was operated with transabdominal perifascial nephrectomy with homolateral adrenalectomy, total ureterectomy and in 28 patients retroperitoneal lymphadenectomy. The 5-year survival was 51% in the patients operated with intrafascial nephrectomy and 84% in the patients operated with perifascial nephrectomy. The difference in prognosis is statistically significant (p less than or equal to 0.01) and cannot be explained by differences in extent of tumor infiltration, tumor grade or tumor size. The main difference in prognosis between the two series was in patients with high stage tumors (Grabstald stage 3 and 4). The 5-year survival was 74% in patients with stage 3 and 4 tumors in the patients operated with perifascial nephrectomy compared with 37% in the patients operated with intrafascial nephrectomy. Since it is not possible with absolute certainty to determine tumor stage before the operation, an aggressive attitude against urothelial renal pelvic tumors is recommended. Thus the patients should undergo transabdominal perifascial nephroureterectomy including a cuff of the bladder wall and homolateral adrenalectomy. In patient with bilateral tumors, renal insufficiency of tumor in a single kidney parenchyma saving partial resection must be performed.

Adult↗
PubMed1977

Tumours of urinary bladder and ureter associated with abuse of phenacetin-containing analgesics.

Forty-two patients with a bladder tumour and 4 patients with a ureteral tumour and a history of abuse of phenacetin-containing analgesics were studied. The sex ratio was 1:1, and the mean age 63 years. The estimated amount of ingested phenacetin was 7.1 kg, the estimated mean exposure time 21 years, and the estimated mean induction time 30 years. Renal papillary necrosis and impaired renal function were found in 34 patients. A history of recurrent urinary tract infection was found in 80 per cent of the patients, suggesting that the combination of phenacetin-abuse and chronic inflammation might be responsible for the localization of the tumours to the bladder. The majority of the bladder tumours were of low grade (1 and 2); muscular invasion was seldom found and metastases were rare. The patients were followed for 1.5-13 years. Twenty-six patients died; the mean survival time was 46 months. Uremia due to analgesic nephropathy was the main cause of death in 14 patients and contributed to death in another 7 patients. Three of the patients with ureteral tumours had received radiological treatment against the pelvic region, 15-20 years prior to the diagnosis of the ureteral tumour.

Adult↗
PubMed1977

Resection of the abdominal wall in metastasis from cancer of the bladder, kidney or colon.

Metastases in the abdominal wound occur in about 1% of a material of bladder tumors and less frequently in renal or colon carcinoma. They are sometimes accompanied by metastases elsewhere. Even if the abdominal wall metastases are very large, extensive resection of all layers of the wall may enable the patient to survive for more than 5 years. Free skin grafts are sometimes sufficient to cover the defect. There is no herniation and no impairment of respiration. Metastases in the vicinity of a colostomy or ileostomy may necessitate an operation. Radiation does not appear to provide any relief.

Abdominal Muscles↗
PubMed1976

A clinicopathologic and prognostic study of epithelial tumors of the renal pelvis.

The aim of the present investigation was to assess the prognosis of epithelial pelvic tumors and evaluate from multivariate analysis the influence of different morphologic and clinical factors on the prognosis. The basic data are derived from the Swedish national series of patients with epithelial renal pelvic tumors diagnosed by histologic examination during 1962-63. Ninety-four of the 102 patients studied had a urothelial pelvic tumor and eight had an epidermoid carcinoma. The corrected 5-year survival rate was 51% in the curatively operated series, 60% among the males and 33% among the females. Infiltration depth was found to be of significant importance for the 5-year survival and thus a strong predictor for prognosis. Furthermore, each tumor grade and tumor structure exerts some influence on the prognosis independent of the infiltration depth. Nine patients had verified, and 16 patients had suspected phenacetin abuse and/or renal papillary necrosis. The survival rate was low and the relative frequency of females was high in this group of patients. These data may indicate a poorer prognosis in patients with phenacetin abuse, and may explain the sex difference in 5-year survival. Thirty-eight per cent of the patients with urothelial tumors of the renal pelvis had a synchronous or asynchronous tumor elsewhere in the urinary tract. The high frequency of local recurrence as well as the high frequency of infiltrating tumors and multiple tumors indicate the necessity for a more extensive operation such as perifascial nephrectomy with total ureterectomy including a cuff of the bladder.

Adult↗