Biomedical subjects

M Medl

Publications and source records attributed to M Medl.

41 records · Page 3Linked to original sources

PubMedDate not supplied

Triptorelin (D-Trp-6-LHRH) in combination with carboplatin-containing polychemotherapy for advanced ovarian cancer: a pilot study.

In experimental and clinical phase II trials GnRH agonists were shown to possess antitumor activity in ovarian cancer. The outcome of prostatic cancer was also improved experimentally by a combination of cytostatic chemotherapy and GnRH analogs. Encouraged by these results, we administered micro-encapsulated triptorelin (Decapeptyl CR), 3.75 mg on the first day of each chemotherapy course, to 15 patients with advanced ovarian cancer in addition to adjuvant, carboplatin-containing chemotherapy (Carboplatin, Epirubicin, Prednimustine and Carboplatin, Etoposide) after radical surgery. Patients received a total of 6 courses. After the completion of combined chemotherapy GnRH analogs were continued for another 6 months at 28-day intervals. Results were compared with those obtained in a group of 15 ovarian cancer patients receiving the same chemotherapy regimen without GnRH medication. At a median follow-up of 36 months no significant differences were seen in terms of response, survival and time to progression. However, patients undergoing chemotherapy+triptorelin tended to show a more positive outcome than those on chemotherapy alone. G1 and G2 tumors in particular were found to respond better to the combined treatment regimen.

Adult↗

PubMedDate not supplied

Tumor-associated trypsin inhibitor (TATI) and cancer antigen 125 (CA125) in patients with epithelial ovarian cancer.

In 180 patients with epithelial ovarian cancer and 214 women with benign pelvic pathologies, serum levels of TATI (cut-off point 21 ng ml-1) and CA 125 (cut-off point 35 U ml-1) were determined. Data were correlated with tumour stage, histological type and tumour grade. Overall, when used as a single marker, TATI showed a sensitivity of 63% and a specificity of 72%, whereas the sensitivity and specificity of CA 125 > 35 U ml-1 were 80% and 82% respectively. A combination of the two markers increased the sensitivity to 91% (TATI > 21 ng ml-1 or CA 125 > 35 U ml-1), whereas the specificity decreased to 65%. TATI was clearly superior in diagnosing mucinous carinomata of the ovaries; the rate of true positive findings was 64% versus 50% for CA 125. Unlike CA 125, TATI levels correlated well with tumour grade. In conclusion, CA 125 remains the single tumour marker of choice in the diagnosis of malignant epithelial ovarian cancer, while TATI appears to be a valuable complementory marker with a higher sensitivity in cases of poorly differentiated and mucinous carcinomata.

Adenocarcinoma, Mucinous↗

PubMedDate not supplied

The application of fibrin glue after axillary lymphadenectomy in the surgical treatment of human breast cancer.

Experimental studies point out that a reduction of lymph flow can be obtained by the local application of fibrin glue following axillary lymphadenectomy in the surgical treatment of breast cancer. In a prospective study the influence of human fibrin glue on postoperative axillary lymph secretion and the period of drainage of the wound cavity were evaluated. In 40 patients, 5 ml of fibrin glue (Tissucol) was applied to the wound cavity by the use of a spray applicator (Tissumat) immediately after axillary dissection of the lymph nodes. For drainage of the wound area Redon suction-drains were used. The daily amount of postoperative lymph secretion was measured and drains were removed at a lymph secretion of less than 20 ml. 40 patients who underwent surgery and axillary lymphadenectomy without subsequent application of fibrin glue sourced as control group. No significant difference concerning the total amount of lymph secretion, the mean period of drainage or the incidence of lymphatic cysts was observed. In our study, the expected occlusion of the wound cavity by the application of fibrin glue after axillary lymphadenectomy did not lead to any advantage when compared with the control group.

Adult↗

PubMedDate not supplied

Endometrial cancer after tamoxifen treatment: a descriptive study of 25 breast cancer patients who subsequently developed endometrial cancer.

The aim of this study was to determine whether tamoxifen affects the histopathological features and clinical outcome of endometrial cancer occurring after breast cancer. 25 patients with a history of breast cancer who subsequently developed endometrial cancer were identified by computer assisted linkage of the Lainz Medical Center Tumor Registry with the National Austrian Cancer Registry. 8 endometrial cancers were tamoxifen-associated, whereas 17 cases were not. The median time of tamoxifen use was 32 months, with a median cumulative tamoxifen dose of 27 g. Detailed histopathological data did not show substantial difference between the two groups. The distribution by stage (FIGO) in the tamoxifen group was Stage I, 7 (87.5) with 1 patient unstaged (12.5%); and Stage I, 13 (76%), II, 2 (12%) and, stage III 2 (12%) for the non-tamoxifen users. No risk of high-grade endometrial lesions with a poor prognosis was found. The only suggestion of a difference was a trend for the mean interval between detection of breast and endometrial cancer to be shorter in the tamoxifen group (50.5 vs. 88.1 months p = 0.07). The conclusion to be drawn from this study appears to be that endometrial cancers occurring after tamoxifen exposure are of the same tumor type. Due to the small number of cases described we were not able to disprove the hypothesis that tamoxifen associated tumors were different in terms of clinical outcome and survival. Regular gynecological examinations are recommended for all breast cancer patients.

Aged↗

PubMedDate not supplied

TATI (tumor associated trypsin inhibitor) and cancer antigen 125 (CA 125) in patients with early-stage endometrial cancer.

BACKGROUND: In patients with gynecologic malignancies, a 6 kD polypeptide known as the tumor-associated trypsin inhibitor (TATI) is present in high concentrations, both in the urine and the serum. This study attempts to evaluate the usefulness of pretreatment serum levels of TATI (cutoff level 21 ng ml-1) and CA 125 (cutoff levels 35 U ml-1 and 65 U ml-1) in the prediction of early endometrial cancer. PATIENTS AND METHODS: One hundred twenty-seven patients with stage I and II endometrial carcinomas, 110 healthy women and 258 women with benign pelvic pathologies were evaluated. The data obtained were correlated with the tumor stage and tumor grade. RESULTS: Overall, TATI showed a sensitivity of 31% and a specificity of 81%. The sensitivity and specificity of CA 125 > 35 U ml-1 was 25% and 86%, respectively. When both serum tumor markers were combined the sensitivity increased to 48% (CA 125 > 35 U ml-1), with a specificity of 71%. A correlation with the depth of myometrial infiltration was found for neither of the tumor markers under investigation. In addition, neither TATI nor CA 125 correlated well with tumor grade. The combination of TATI and CA 125 had a high positive predictive value (84%) when no other gynecologic pathologies were present. Furthermore, if TATI and CA 125 levels are within normal ranges and gynecological examination does not show other abnormalities besides vaginal bleeding, endometrial carcinoma appears to be very unlikely. CONCLUSION: We concluded that, while TATI and CA 125 may not be recommended as a screening method for the detection of endometrial cancer, the combination of TATI and CA 125 is a valuable additional tool for further evaluation of women with suspected uterine cancer.

Adult↗