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N Vavra

Publications and source records attributed to N Vavra.

At least 91 records · Page 5Linked to original sources
PubMed1990

Benefit of external irradiation in pathologic stage I endometrial carcinoma: a prospective clinical trial of 605 patients who received postoperative vaginal irradiation and additional pelvic irradiation in the presence of unfavorable prognostic factors.

Six hundred and five cases of endometrial carcinoma, pathologic stage I, without definable extrauterine disease were initially treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy, followed by high-dose-rate iridium-192 irradiation of the vagina. External irradiation of the pelvis was performed only for patients with poor prognostic factors. Five-year survival was calculated by the product-limit method of Kaplan and Meier. Three hundred and forty-eight patients with tumor invasion of the inner third, of any tumor grade, received postoperative vaginal irradiation only. Twenty-eight patients with grade 1 tumor invasion of the middle third received vaginal irradiation only. One hundred and six patients with grade 2 or 3 tumor and infiltration of the middle third received vaginal and external irradiation of the pelvis. One hundred and twenty-three patients with deep muscle invasion of the external third of the myometrium received vaginal and pelvic irradiation. Differences in survival figures were not significant. Survival of the treatment group with good prognosis who received vaginal irradiation alone (91%) was similar to that of the group with poor prognosis who received additional pelvic irradiation (87.7%). Despite the unfavorable situation of patients with poor prognostic factors, treatment results after additional external irradiation were relatively equal to the results for patients with good prognostic factors who had not received external irradiation. Therefore, the benefit of external irradiation in patients with stage I endometrial carcinoma with unfavorable prognostic factors seems evident.

Aged↗
PubMed1990

[Effect of inguinal lymph node irradiation on the treatment result of vulvar cancer with different risk factors].

The clinical data from 101 patients with invasive squamous cell cancers of the vulva with less than 10 mm stromal invasion in depth, treated between 1972 and 1983, were studied. 43 of these patients underwent merely a radical vulvectomy, the remaining 58 patients underwent a combination therapy of vulvectomy and irradiation of inguinal lymph nodes. Although the majority of risk factors, like clinically suspicious nodes, stromal invasion of more than 5 mm, tumour expansion of more than 2 cm and clitoral location, occurred more frequently (p<0,001) in the combination therapy group. There was no statistical significance in the five-year survival rate between our two therapy groups (88,4% versus 79,3%). In stage I and II cases inguinal relapses occurred in the group with vulvectomy alone in 9.3%, in the group with adjuvant external irradiation of the inguinal fields in 2.6%. We believe, the data presented show the important role of radiotherapy of inguinal nodes in the curative management of vulvar cancer.

Adult↗
PubMed1990

[Value of irradiation alone of generally inoperable endometrial cancer with high dose rate iridium 192].

Surgery should be an integral part of the management of the patient suffering from endometrial cancer. Only patients with severe internal diseases should be treated with radiation therapy alone. Although radiation therapy alone can cure endometrial cancer, the survival figures are poorer than for the operation. At the University of Vienna (1st Department of Gynaecology), 267 patients with endometrial cancer were treated by radiation therapy alone (Afterloading iridium192 technique). 5-year survival (life table method) for all patients was 65.2%. In stage I, 5-year survival was 66.9%, and in stage II 46.7%, respectively. For up to 69 years of age the survival was 76.6%, for 70 years and more 61.8%, for grading I 78.8%, for grading II and III only 55.4%, respectively. With radium226 technique, the survival rate was only 56%, while 65.2% were reached with the Iridium technique. All differences are significant. External irradiation (cobalt60) was employed as combined treatment in only 9.4% of the cases. Intrauterine and intravaginal applications were performed without anaesthesia and the hospitalisation time was only one day per week. The relapse rate in stage I/b was 14.8% and in stage II 30%, respectively. Therefore, the dose of intracavitary treatment should be changed and external irradiation used more often.

Aged↗
PubMed1990

Oestrogen and progesterone receptor content as a prognostic factor in advanced epithelial ovarian carcinoma.

Levels of oestrogen receptor (ER) and progesterone receptor (PgR) in ovarian cancer tissue were examined with regard to their prognostic importance for survival in 179 patients with primary epithelial ovarian cancer stage III or IV in relation to: FIGO-stage, histological type, histological grade, age, ascites, and postoperative residual tumour. Hormone receptor content was determined with the DCC-method, receptor values higher than 9 fmol/mg protein were considered positive. Response to postoperative chemotherapy was significantly correlated with PgR content (80% responders in the group with PgR positive tumours and only 61% responders in the group with PgR negative tumours). A Cox proportional hazards regression model identified histological grade, residual tumour, age and PgR content as independent prognostic factors for survival in advanced epithelial ovarian carcinoma. PgR content had particularly significant prognostic relevance for patients with postoperative residual tumour mass less than or equal to 2 cm in diameter. Within this group of patients, those who are PgR positive have a 2-years survival probability of 83% compared with only 51% in the PgR-negative group.

Female↗
PubMed1989

[Results of electrosurgical vulvectomy with postoperative irradiation of the inguinal lymph nodes in vulvar cancer].

Clinical data on 669 patients with invasive squamous cell carcinoma of the vulva were seen between 1952 and 1982. All of these patients were available for 5-year evaluation. The crude survival for these patients was 62%, and the "cleaned" 5-year survival for 585 patients was 70%. All patients were treated with radical vulvectomy using the warm knife and open-wound technique. Treatment of the regional lymph nodes was performed by irradiation alone. This simple surgical technique in combination with radiotherapy applied only to the inguinal lymph nodes gives an excellent result without the complications associated with aggressive surgery.

Aged↗
PubMed1989

Diagnostic value of mucin-like carcinoma-associated antigen (MCA) in breast cancer.

The diagnostic value of mucin-like carcinoma-associated antigen (MCA) was compared to that of carcinoembryonic antigen (CEA) and/or CA 15.3 in patients with breast cancer. A total of 368 patients with breast cancer were studied, of whom 253 were free of metastases, whereas 94 had either skeletal or visceral metastases or diffuse metastatic disease. The diagnostic sensitivity of MCA proved to be comparable to that of CA 15.3 and superior to that of CEA in patients with metastatic breast cancer. In contrast, the specificity of MCA was superior to that of CA 15.3. Finally, the diagnostic sensitivity of each of the tested tumour markers, i.e. MCA, CEA and CA 15.3, could be improved by their combined use. We conclude that MCA, either alone or in combination with CA 15.3 and CEA, can improve the monitoring of disease progression in patients with metastatic breast cancer.

Antigens, Neoplasm↗
PubMed1989

[The value of postoperative irradiation in endometrial cancer of pathohistologic stage I].

In a prospective therapeutic study, 571 cases of endometrial cancer in pathological stage I were treated initially with total hysterectomy and received 6 weeks after surgery double high-dose-rate iridium 192 irradiation of the vagina (afterloading technique). The single dose was 700 cGY (at 2 cm distance from the applicator axis). Postoperative treatment planning was based on the prognosticators of depth of myometrial invasion and tumor grading with subtypes. External irradiation was prescribed only for patients with poor prognostic factors (Cobalt-60,5600 cGY on the pelvis wall, 30 fractions). At the time of this report, the patients had been followed up for 6 to 96 months after their original therapy. Survival was calculated by the life table method. 327 cases with slight tumor infiltration, independent of the tumor morphology, received postoperative vaginal irradiation only. Survival rate was 90.6%. 27 cases with tumor infiltration of the middle third of the myometrium and grade 1 tumors, received also only vaginal irradiation. Survival rate was 100%. 101 cases with tumor infiltration of the middle third of the myometrium and grade 2 and 3 tumors, received vaginal irradiation plus external irradiation. Survival rate was 89.9%. 116 cases with tumor infiltration of the external third of the mymetrium and any tumor grade, received vaginal irradiation plus also external irradiation. In these patients with poor prognosis, the survival rate was 85%. Differences between groups are not significant. Considering the treatment group with good prognosis and the group with poorer prognosis and the additional external irradiation, the survival figures were quite similar (90.6% and 87.9% respectively). In spite of the unfavorable situation of patients with poor prognosticators, treatment results after the additional external irradiation were rather similar to those cases with good prognosticators and without external irradiation. The value of external irradiation in cases of endometrial cancer in stage I with unfavorable prognosticators seems to be quite clear. This therapy improvement was all the better, because side effects of external irradiation were low (0.2% rectovaginal fistulas) and in case of irradiation of the vagina only, no severe side effects occurred. Relapse rate for the treatment group with good prognosis and vaginal irradiation only was 0.6% (2 from 354) and for the group with poor prognosis and additional external irradiation 2.8% (6 from 217) respectively.

Adult↗
PubMed1989

[The value of primary irradiation of invasive adenocarcinoma of the uterine cervix].

Of 1484 patients with invasive carcinoma of the cervix who underwent primary radiotherapy, 65 (4.4%) were found to have adenocarcinoma. These adenocarcinoma patients were matched with squamous cell carcinoma patients on the basis of age, stage and 5-year survival rates. In 703 patients with squamous cell carcinoma, there was no difference in age and stage compared to those patients, who had an adenocarcinoma of the cervix. The cumulative 5-year survival rates for 65 patients in the adenocarcinoma group (30.7%) were not significantly different, but were remarkably lower with the squamous cell control subjects (42.7%). Only the 5-year survival results for patients with FIGO stage 2 disease were significantly less than those of our control group. For patients with stage 3 disease there were nearly the same results (30%) in both groups. Our results underline the importance of radiotherapy for the treatment of inoperable patients with invasive adenocarcinoma of the uterine cervix.

Adenocarcinoma↗