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N Vavra

Publications and source records attributed to N Vavra.

At least 73 records · Page 4Linked to original sources
PubMed1991

[Ferritin level in newborn infants after prepartal iron medication].

Aim of the study was to find out the influence of iron medication of pregnant women on the iron levels of their newborn. In a prospective randomised study the iron-substituted group (n = 57) was treated with 2 x 1 Aktiferrin comp. Kps. (Merckle) during pregnancy, starting from the 22nd week. The control group (n = 46) had no medication during pregnancy. The substituted group had statistically significantly higher serum ferritin levels in the 30th week of pregnancy (p less than 0.048), higher levels measured in the cord blood at birth (p less than 0.001), and also the newborn of this group had statistically significant higher serum ferritin levels than the newborn of the control group (p less than 0.001). Our conclusion is that prepartal iron medication leads to increased iron stores in the newborn.

Female↗
PubMed1991

[Melanoma of the vulva. Report of 12 cases].

The present retrospective study includes 12 patients with melanoma of the vulva who underwent vulvectomy between 1977 and 1987. Six patients were less than 55 and 6 other patients more than 69 years old. Three women of the younger age group survived (31, 44 and 116 months, respectively), whereas three of them died of the tumour. In the patient group of over 69 years of age 4 patients died of the tumour, one patient did not appear for follow-up and one further patient died in the meantime. Nine patients suffered from deeply infiltrating tumours (Clark levels IV and V), 2 patients had a Clark level II tumour, and in one case the Clark level was unknown. Depth of infiltration correlated with the prognosis of disease, i.e. only one patient with deep tumour infiltration, but both patients with Clark level II tumours survived. Therefore, the importance of early diagnosis of melanoma of the vulva should be emphasized, and accurate inspection of the vulva should be indispensable in the course of routine gynaecological examination also in younger women.

Adult↗
PubMed1991

[Effect of various factors on survival after recurrent and/or metastatic breast cancer].

145 women (22.2%) out of 652 patients with primary breast cancer, who were operated on between January 1980 and September 1988, developed tumour relapse until May 1990. The aim of our retrospective analysis in these 145 patients with local and/or distant tumour relapse was to evaluate the prognostic importance for further survival of the following factors: menopausal status, stage of disease, number of involved axillary lymph nodes, tumour grading, ER and PgR content, postoperative irradiation, adjuvant treatment, localisation of tumor relapse and relapse-free interval. Multivariate stepwise regression analysis of all these factors identified the number of positive axillary lymph nodes (0-3 versus 4+) with a relative risk (RR) of 2.49 and localisation of tumour relapse (local versus visceral metastasis RR = 2.08 and local versus bone metastases RR = 2.08) as the only two significant prognostic factors for further survival. Therefore, these two factors should be stratification criterias for prospectively randomized phase III studies in patients with tumour relapse after primary breast cancer.

Adult↗
PubMed1991

[Effects of primary radiotherapy on uterine circulation in advanced cervix cancer].

We examined 11 patients suffering from advanced cervical carcinomas, who were treated primarily with radiation. The blood flow through the uterus was established by measuring the Doppler pulse flow through the arteria uterina before and after radiotherapy. In a reference group of 25 women, free from cervical carcinomas, we established a median PI of the arteria uterina of 3.52 (+/- 1.10) with values between 1.64 and 5.06. In contrast, the group of 11 patients suffering from inoperable cervical carcinomas, were found to have a PI of 1.80 (+/- 1.40), with values between 0.41 and 4.41 (Wilcoxon Test: p = 0.001). After completion of the radiotherapy, 7 of the 11 patients showed no measurable pulsations of the arteria uterina, 3 patients had only systolic blood flow and only one patient had the same unchangingly high rate of blood flow as registered before radiotherapy. The significantly reduced flow of blood through the tumour tissue after radiotherapy, indicates a very limited response to chemotherapy. Therefore, chemotherapy should be administered before radiotherapy.

Adenocarcinoma↗
PubMed1991

[Conization in pregnancy and its significance for the further course of pregnancy].

The influence of cold knife conisation on further progression of pregnancy was analysed in 28 patients, who underwent the operation during pregnancy. 13 women were operated on within the first 16 weeks of gestation (group I) and were compared to 15 patients, where conisation was done in the 17th week or later (group II). In the first group, deliveries were found in the 39th week of pregnancy compared to 34 weeks in the second group (p.05). A statistical significant difference concerning the further duration of pregnancy after conisation was found: 25 weeks in group I vs. 11 weeks in group II (p. 0012). There was no difference, however, in radicality whether conisation was done in early or late pregnancy. Our final conclusion is, that a preterm delivery occurs significantly more often in women who underwent conisation after 16th week of gestation.

Abortion, Spontaneous↗
PubMed1991

Ultrasonic Doppler flow studies of the uterine arteries in women with cervix cancer.

The main characteristic of malignant tumors is their capacity for local destructive spread as well as infiltration into the adjacent tissue. The present study was carried out to evaluate the hemodynamic alterations in patients with advanced cervix cancer. Data of 34 patients with cervix cancer are compared to 30 healthy women with normal history. The mean pulsatility index (PI) was significantly lower in cancer patients (PI = 1.75 +/- 1.27) than in controls (PI = 3.18 +/- 0.99). Use of noninvasive Doppler ultrasound study physiology of uterine hemodynamics in patients with cervix cancer is of great clinical relevance and paves the way for further investigations in screening programs for cervix cancer.

Arteries↗
PubMed1991

Lymphoscintigraphy using epidermal growth factor as tumour-seeking agent in uterine cervical cancer.

Fourteen patients suffering from advanced inoperable cervical cancer were investigated by planar scintigraphy after subcutaneous administration of a radiolabelled (I-123) epidermal growth factor (EGF). The objective of the study was to test whether labelled EGF concentrates in lymph node metastases of squamous cell cancer of the cervix uteri. Scintigraphic results were correlated with the gynecological findings, computed tomography (CT), ultrasound (US) and in two patients with histology. A series of scintigrams were performed up to 24 hours post injection. Slight activity in liver and kidneys was found already 30 min after s.c. injection of EGF. Optimal imaging quality for the lymphatics was obtained at 6-8 hours post injection. Accumulation in the pelvic lymph nodes was documented by the region of interest technique (ROI). Lymph nodes of the inguinal and iliac communis region were marked in all cases. Due to this, accumulation of EGF could not be called selective. In 11/14 patients hot spots were correlated to other pelvic lymph nodes. In 4/11 patients with positive EGF-scanning metastatic disease was confirmed by CT scan and/or US examination. 2/11 patients underwent a Probatoria operation. The respective histological reports confirmed our scintigraphic results. In conclusion, labelled EGF did not fulfil our theoretical expectations of excellent accumulation in lymph node metastases and cannot at present be recommended for routine clinical use.

Carcinoma, Squamous Cell↗
PubMed1991

[The value of adjuvant irradiation in patients with cervical carcinoma in histopathological stage Ib and negative lymph nodes].

The present retrospective study attempts to evaluate the significance of adjuvant radiotherapy as a prognostic factor for stage Ib cervical carcinoma without lymph node metastases in addition to factors such as age, histological type, histological grading and tumor size. Between 1975 and 1987 224 patients were operated at our department or referred to postoperative radiotherapy and fulfilled the inclusion criteria: histopathological stage Ib, radical hysterectomy with pelvic lymphadenectomy and negative pelvic lymph nodes. The multivariate analysis confirmed that tumor size (tumor infiltration of the cervix greater than 2/3 vs less than 2/3: RR = 4.48) and histological grading (G3 vs G1 + G2: RR = 3.12) are significant prognostic parameters for survival. Postoperative adjuvant irradiation is a marginal significant factor for survival in stage Ib cervical carcinoma and negative nodes (RR = 3.22; p = 0.057). For women with negative nodes but high-risk prognostic factors in the cervix, a prospective randomized trial proving the value of postoperative irradiation would be of therapeutic interest.

Combined Modality Therapy↗
PubMed1991

[Radiotherapy of primary vaginal carcinoma and effects of histological and clinical factors on the prognosis].

434 cases of primary vaginal carcinoma were treated from 1950 to 1984 at the Irradiation Department of the University Clinic for Obstetrics and Gynecology, Vienna. The five-year survival rate for various clinical stages is as follows: Stage I 76.7%, stage II 44.5%, stage III 31%, stage IV 18.2%. In this retrospective study 110 patients seen from 1975 to 1984 were reviewed in detail and evaluated with a view toward their clinical and morphological aspects and survival rates. Patients up to the age of 60 have a five-year survival rate of 50%, those over 75 years of age reach only 34.3%. If the carcinoma was discovered in a routine check up the survival rate is 61.1%, whereas in cases with symptoms the rate decreases to 36.9%. Survival differences were also observed for patients with a carcinoma in the upper third of the vagina (61.1%) versus patients with a carcinoma in the lower third (33.3%); for patients with well-differentiated tumours (62.5%) versus patients with grades II and III (41.5% and 34.9%). It can be seen, that with brachytherapy local control of the carcinoma can be achieved with excellent results in early stages. Treatment of patients with more advanced carcinomas should include external beam therapy. The importance of gynecological screening especially for older women is emphasized.

Adenocarcinoma↗
PubMed1990

[A risk score for surgically treated stage Ib cervix carcinoma and its significance for postoperative irradiation].

The value of adjuvant irradiation in stage Ib cervical cancer is not clear. In a retrospective study of 171 cases of stage Ib cervical cancer tumor grading, tumor size, blood and lymphatic vessel invasion and pelvic lymph node metastases were analysed. A simple score of these risk factors is proposed enabling assignment into patient groups of similar risk on the basis of a points system for individual prognostic factors. 90 patients were treated by radical surgery alone, 81 patients received adjuvant pelvic irradiation (56 Gy). 5-year survival after surgery alone was 95.6%, in comparison with only 79% after adjuvant irradiation (p less than 0.001). However, when patients with a similar risk score are compared, the outcome of adjuvant irradiation was found to be favourable. With a score of 6 to 10 points 5-year survival after surgery alone was 75%, whilst with adjuvant irradiation the rate rose to 92%. In this risk group relapses were observed after surgery alone in 37%, whilst with adjuvant irradiation only 4% relapsed. 20 of 21 deceased patients had a risk score of 6 and more points. The incidence of risk factors in the group treated by surgery alone was significantly lower than in the group with adjuvant irradiation (p less than 0.0001). Therefore the unfavourable result in the group given adjuvant irradiation becomes quite clear. Adjuvant irradiation is recommended in stage Ib cervical cancer for patients with a risk score of 6 and more points. Adjuvant radiotherapy should not be hastily replaced by other modalities of adjuvant treatment.

Cobalt Radioisotopes↗
PubMed1990

[The value of surgical staging in the early stages of ovarian carcinoma].

The value of surgery in early ovarian cancer was assessed in a retrospective analysis of prognostic factors in all 222 patients with primary stage I epithelial ovarian carcinoma treated in this department between 1975 and 1987. Only cellular differentiation grade (p less than 0.03) and surgical procedure - total abdominal hysterectomy, bilateral salpingo-oophorectomy +/- omentectomy vs. unilateral salpingo-oophorectomy - (p less than 0.02) were of significant influence on estimated survival (Cox model). All other factors (age, FIGO stage, integrity of the capsule, uni-vs. bilaterality, histology) were of no prognostic importance. Unilateral salpingo-oophorectomy without any additional staging reduces the 5-year survival probability (62% vs. 84%). Future prospective studies on adjuvant therapy must be based on exact staging during surgical management before randomisation. Determination of cellular differentiation is also essential.

Adult↗
PubMed1990

[The value of cytoreductive second-look surgery in advanced epithelial ovarian carcinoma].

40 patients with advanced epithelial ovarian carcinoma were investigated to evaluate the influence of further cytoreduction during second-look surgery on survival after termination of first-line polychemotherapy containing cisplatinum. Radical tumorectomy with no macroscopic residual tumor mass was achieved in 27.5% of cases; in 52.5% the residual tumour mass was less than 2 cm and in 20% it was more than 2 cm in diameter after cytoreductive second-look surgery. Median survival time after second-look within these three groups of patients was 15.2 months, 16.9 months and 15.3 months, respectively (Mantel test, p = 0.74). In contrast to the situation at the diagnostic operation, further cytoreduction during second-look surgery has no positive influence on survival. We therefore abandoned this operation in clinically tumour-positive patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Prognostic factors for survival in stage I epithelial ovarian carcinoma.

In a retrospective analysis prognostic factors were studied in 204 patients with primary Stage I epithelial ovarian carcinoma (borderline tumors were excluded) treated between 1975 and 1987. Only histologic grade (P = 0.01) and kind of surgery (total abdominal hysterectomy, bilateral salpingo-oophorectomy +/- omentectomy versus unilateral salpingo-oophorectomy, P = 0.02) were found to have a significant influence on survival prognosis (Cox model). All other factors (age, the International Federation of Gynecology and Obstetrics [FIGO] stage, integrity of the capsule, unilaterality versus bilaterality, and histology) were of no prognostic importance. Unilateral salpingo-oophorectomy without any additional staging reduces five-year survival probability (62% versus 84%). Therefore this kind of operation should be abandoned. Furthermore, histologic grade should be a stratification criterion in studies, which will be necessary for proving the value of adjuvant therapy in Stage I epithelial ovarian carcinoma.

Carcinoma in Situ↗
PubMed1990

[Risk factors in stage I squamous cell epithelial cancer of the vulva and their effect on results of therapy].

A total of 113 cases of carcinoma of the vulva, stage I, were retrospectively (1972-1983) evaluated with respect to the clinical and morphological findings. 14 of the patients developed a recurrence. The five-year period survival rate was 84.9% and the corrected survival rate was 92.5%. 79 of these patients underwent radical vulvectomy only. The other 34 patients received combination therapy of vulvectomy and irradiation of the inguinal lymph nodes. Our surgical technique of using the warm knife and open-wound technique in combination with radiotherapy applied only to the inguinal lymph nodes gives excellent results without the complications associated with aggressive surgery.

Adult↗