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N B Johannessen

Publications and source records attributed to N B Johannessen.

9 recordsLinked to original sources
PubMed1994

How safe is surveillance in patients with histologically low-risk non-seminomatous testicular cancer in a geographically extended country with limited computerised tomographic resources?

In patients with clinical stage I non-seminomatous testicular cancer only limited information is available about the administrative problems with the surveillance programme, in particular if this policy is to be implemented in a geographically extended country with limited computerised tomography (CT) resources. One hundred and two patients with non-seminomatous testicular cancer clinical stage I and low-risk histology (MRC criteria, UK) were followed by the surveillance policy for at least 1 year after orchiectomy (median 47 months, range 21-81 months). Twenty-two patients (22%) relapsed after a median time of 5 months (range 2-18 months), 14 of them in the retroperitoneal space. Serum alpha-fetoprotein and/or human chorionic gonadotrophin were elevated in eight of the 22 relapsing patients. The progression-free and cancer-corrected survival rates were 78% and 99% respectively. Patient non-compliance did not represent a major problem, whereas the regular and adequate performance of necessary CT examinations yielded some administrative difficulties. One and 3 years after orchiectomy about 50% of the relapse-free patients had no psychological problems and were satisfied with the surveillance programme, whereas 46% reported minor and 4% major psychological distress. Despite non-negligible administrative difficulties in geographically extended countries, surveillance is feasible and safe in compliant patients with low-risk non-seminomatous testicular cancer stage I. The responsible cancer centre and the local hospitals should establish a high degree of cooperation and enable adequate follow-up examinations in these patients.

Biomarkers, Tumor↗
PubMed1987

The treatment of advanced metastatic seminoma: experience in 55 cases.

Thirty-six of 39 previously untreated evaluable patients with advanced metastatic seminoma (stage greater than or equal to IIb) obtained a complete response (CR) and three a partial response (PR) after cisplatin-based combination chemotherapy with or without surgery/radiotherapy (group 1). After a median observation time of 36 months, 33 patients are alive with no evidence of disease (NED). Fifteen additional patients received cisplatin-based chemotherapy due to relapsing seminoma after initial radiotherapy (group 2). Thirteen patients obtained a CR, and two a PR. Patients from group 1 lived significantly longer after the start of chemotherapy than those from group 2. The rate and severity of the treatment-related complications were comparable in both groups. The most frequent nonfatal side effects of cisplatin-based combination chemotherapy were Raynaud-like phenomena, polyneuropathy, and myelosuppression. Four patients developed fatal complications (septicemia, bone marrow aplasia). In three of 12 patients with evaluable postchemotherapy histology, vital malignant seminoma was found. Cisplatin-based combination chemotherapy in advanced seminoma patients is highly effective, but includes a significant risk of severe complications. Less toxic treatment regimens should be explored, at least for patients who have less advanced tumors (stage IIb/limited stage IIc).

Adult↗
PubMed1987

Pre-cystectomy chemotherapy in patients with muscle infiltrating bladder carcinoma. A multicentre feasibility study.

Fourteen patients with muscle infiltrating bladder cancer in whom total cystectomy was planned, received 3 cycles of cis-platinum (70 mg/m2 Day 1) and Methotrexate (40 mg/m2 Day 1) with 3-week intervals before pelvic radiotherapy (20 Gy). Thirteen patients underwent cystectomy whereas the remaining patient finally was found to be inoperable. The subjective toxicity (nausea, vomiting, decrease of performance status), the hematological side effects and the nephrotoxicity of this pre-cystectomy treatment were acceptable. In particular, the treatment did not increase the per- and postoperative complication rate as long as patients were selected who were good risk candidates for major surgery. Stage reduction (P less than T) was seen in 9 of 13 patients. Combination therapy with cis-platinum/methotrexate and short term pelvic radiotherapy is feasible as adjuvant pre-cystectomy treatment in patients with muscle infiltrating bladder cancer. The possible therapeutic superiority of this adjuvant treatment has to be shown in randomized trials.

Aged↗
PubMed1987

Cancer of the penis. Experience at the Norwegian Radium Hospital 1974-1985.

The cancer-related 5-year survival was 80% in 79 patients with penile cancer treated at the Norwegian Radium Hospital from 1974 to 1985 (N0 = 61, N1-2 = 12, N3 = 6). Sentinel node biopsy (SLN) of the inguinal lymph nodes medial to the saphenous vein helps to identify patients with early regional spread. The survival for these N+ patients is favourable if radical lymph node dissection is performed immediately. A tumour-negative SLN biopsy does, however, not exclude the subsequent development of inguinal lymph node metastases. These were found equally often during follow-up in patients with or without primary performance of SLN biopsy. Five of 6 patients, relapsing with groin metastases, were cured by secondary lymph node dissection. Most of the small primary tumours (T1/T2) can be treated radically by primary radiotherapy, but frequent follow-up is necessary to detect surgically curable penile recurrences (3 of 11 patients). Combination treatment of chemotherapy, radiotherapy and surgery represents a good palliation treatment in advanced cases.

Adult↗
PubMed1986

Diagnostic efficiency of biological markers in blood serum on prostate cancer: a comparison of four different markers and 12 different methods.

Serum-acid phosphatase as measured by nine different methods, serum prostate-specific antigen, cancer antigen CA-50, and creatine kinase BB isoenzyme have been evaluated and compared with respect to efficiency in differentiating between prostate cancer and benign hyperplasia. The patient material consisted of 92 prostate cancer patients (59 untreated, and 33 previously treated), 106 patients with benign hyperplasia and 66 patients with non-prostatic urological diseases. The cancer group was classified according to the TNM-system, and also graded according to histopathological findings. The following main conclusions were drawn. Acid phosphatase activity, when measured with continuous monitoring procedure (substrate: alpha-naphthyl phosphate), showed on the average slightly, but statistically not significant higher diagnostic efficiency than when measured with conventional two-point discontinuous monitoring method (substrate: p-nitrophenyl phosphate). There was no or only marginal differences in diagnostic efficiency between activity measurements of the total acid phosphatase and the tartrate-labile fraction, and also between activity measurements and immunological measurements (PAP-RIA and PAP-IEA). Prostate-specific antigen was found to have statistically significant higher diagnostic efficiency than acid phosphatase, the former being positive in 17 of 25 patients with prostate cancer without distant metastases, and in six of 11 patients classified as T0-2 M0. Cancer antigen CA-50 and creatine kinase BB isoenzyme appeared to be of little diagnostic value. From a cost-effective point of view, total or tartrate-labile prostatic acid phosphatase activity, as measured by continuous monitoring technique with alpha-naphthyl phosphate as substrate, is suggested suitable as a first-choice parameter both for diagnostic and monitoring purposes with respect to prostate disease. Prostate-specific antigen may give additional information, and should be considered analysed on special request.

Acid Phosphatase↗
PubMedDate not supplied

Computed tomography of invasive bladder carcinoma after diagnostic transurethral resection.

Fourteen patients with known muscle invasive bladder carcinoma were examined with computed tomography (CT) before and five to seven days after diagnostic transurethral resection (TUR). The CT examinations included pre- and postcontrast series. In order to standardize the technique, we examined on a distended bladder. No significant changes occurred for the whole group after TUR. Individual changes were seen. In six patients the largest measured area of the bladder tumor increased after resection and in four the largest measured thickness increased, and this should be borne in mind when CT is used to evaluate tumor response to treatment. Perivesical changes occurred only after extensive diathermy or perforation. They did not show contrast enhancement and could therefore not be mistaken for tumor growth.

Aged↗