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Biomedical subjects

P Kolstad

Publications and source records attributed to P Kolstad.

At least 19 recordsLinked to original sources
PubMed1989

A randomized trial of adjuvant progestagen in early endometrial cancer.

A randomized, controlled trial was designed to determine whether adjuvant progestagen therapy improves survival in patients with Stage I or Stage II endometrial cancer. After surgery, 1148 patients were randomly assigned to adjuvant treatment with progesterone or were given no additional therapy. The duration of follow-up ranged from 42 to 132 months (median follow-up, 72 months). Crude survival and relapse rates were similar for both groups. Death due to intercurrent disease was higher in the progesterone group (P = 0.04). The median survival of the group of patients with cancer-related death was higher in the progestagen group than in the control group (30 and 22 months, respectively; P = 0.03). In 461 high-risk patients, a tendency towards fewer cancer-related deaths and a better disease-free survival in the treatment group was observed, but crude survival was unchanged. We conclude that there is little to gain from adjuvant progestagen therapy in patients with low-risk endometrial cancer, and that further studies are needed in high-risk patients.

17 alpha-Hydroxyprogesterone Caproate↗
PubMed1989

[Cervical intraepithelial neoplasia. Terminology, diagnosis and treatment].

Today cervical intraepithelial neoplasia (CIN I-III) is the most commonly used term for lesions which in earlier years were called dysplasia and carcinoma in situ. The introduction of cytologic smears in the 1960s resulted in a sharp increase in the number of such lesions reported to the Cancer Registry of Norway. Each year close to 900 new cases are registered. Diagnosis and treatment are strongly dependent on colposcopy and endocervical curettage. Ectocervical lesions may well be treated by destructive methods such as cryosurgery, cold coagulation, electrocoagulation diathermy or laser vaporization. For lesions extending up into the endocervix, conisation is the best method, preferably performed by laser. A series of 171 cases of CIN I-III reported during the years 1953-86 shows that invasive cancer may occur also with free margins on the cone, and as long as 10-20 years after primary treatment. Careful and almost life-long follow-up is therefore essential.

Carcinoma in Situ↗
PubMed1989

Follow-up study of 232 patients with stage Ia1 and 411 patients with stage Ia2 squamous cell carcinoma of the cervix (microinvasive carcinoma).

This report retrospectively analyzes 643 patients with microinvasive squamous cell carcinoma of the cervix who were followed-up for 3-17 years. The cases were classified according to the FIGO definition adopted in 1985 which includes a subdivision into Stage Ia1 and Stage Ia2. It is concluded that the new FIGO system has definite advantages for the decision of therapy in microinvasive carcinoma. Unnecessary radical treatment can be avoided.

Adult↗
PubMed1989

Misonidazole combined with radiotherapy in the treatment of carcinoma of the uterine cervix.

Between April 1979 and January 1982, 331 patients were included in a study to establish whether misonidazole (MISO) had any effect as an adjuvant to radiotherapy in the treatment of squamous cell carcinoma of the uterine cervix (FIGO Stage IIb, III, and IVa). Patients were randomized to receive either MISO (12 g/m2 applied within 6 weeks) or placebo. This was given in conjunction with each institution's normal radiotherapy schedule and thus varied with regard to external and intracavitary irradiation. The analysis was performed based on patients' status at January 1986, with all patients observed for at least 4 years. One hundred and sixty-four patients received MISO and 167 placebo. Compliance to radiotherapy was good and MISO was well tolerated. The overall rates for MISO vs. placebo were as follows: local tumour control, 50 vs. 54%; disease-free survival, 47 vs. 46%, and crude survival, 39 vs. 45%. A similar lack of MISO effect was found in the individual stages. However, patients in all stages with hemoglobin concentrations below 7 mmol/l had a significantly lower local control probability (overall 24 vs. 47%), whereas the incidence of distant metastases was unaffected. We conclude that the addition of MISO did not influence the radiation response in advanced uterine carcinoma. The reasons for this ineffectiveness are yet to be clarified.

Carcinoma, Squamous Cell↗
PubMed1987

[Preserving ovarian function in the treatment of epithelial and special (other) malignant ovarian tumors].

About 90% of malignant tumors of the ovary in Scandinavia develop from the germinal epithelium. There are great differences in the incidence rates between countries in the Western world and in Africa and Asia. The WHO classification of ovarian malignancies is generally used. The epithelial tumors comprise the serous, mucinous, endometrioid, clear cell, undifferentiated and mixed true carcinomas. In addition, borderline lesions of especially the serous and mucinous types are of interest when the question of preservation of ovarian function comes into notice. Conservative surgery, which means removal of only the afflicted ovary should be restricted to young women of the childbearing age who want to preserve the possibility of becoming pregnant. However, certain prerequisites must be fulfilled. The tumor must be located to one ovary only (Stage Ia) and must be either a borderline lesion or a Grade 1 true carcinoma of either the serous, mucinous or endometrioid type. There must be no ascites and peritoneal washings must be negative for cancer cells. Germ cell tumors are usually found in young women. Only the dysgerminomas are regularly bilateral in 10-15% of the cases. All other germ cell tumors are rarely bilateral. But both in borderline lesions, Grade 1 true carcinomas, and in germ cell tumors, a biopsy of the normal looking contralateral ovary should always be performed. Endodermal sinus tumors and immature teratomas may well be treated conservatively by surgery, but modern triple chemotherapy (VAC, PVB) must be added. Granulosa theca cell tumors are bilateral in only about 5% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1978

Stage IB carcinoma of the cervix, the Norwegian Radium Hospital, 1968-1970: results of treatment and major complications. I. Lymphedema.

Different methods of treatment have been debated over the years for Stage IB carcinoma of the cervix, especially in view of the results and complications. We have reviewed the experience of the Norwegian Radium Hospital for carcinoma of the cervix, Stage IB, for the years 1968, 1969, and 1970; most of the patients receive preoperative intrauterine and intravaginal radium, followed by radical hysterectomy and pelvic lymphadenectomy; if the nodes are involved, they also receive external pelvic irradiation. During this period, 437 patients had Stage IB; the 5 year survival was 80.2% (not corrected). We focused our attention on lymphedema following such a method of treatment; of 402 patients operated upon, 23.4% developed lymphedema ranging from mild to moderate to severe; 20 patients (5%) had severe lymphedema; factors involved are analyzed.

Adenocarcinoma↗
PubMed1978

Postoperative irradiation and chemotherapy in patients with advanced ovarian cancer.

Two groups of patients with stage III ovarian carcinoma were selected for a randomized clinical trial. The first group consisted of 157 patients who had radical surgery at their first laparotomy, the second group consisted of 145 patients with inoperable disease. The aim of the trial was to compare the results of maximum external megavoltage irradiation, 5 000 rads, to a large abdominal field, with the results of a reduced dose, 3 000 rads, immediately followed by chemotherapy with an alkylating agent (Thio-tepa). In none of the groups, did maximum radiotherapy prove superior to the schedule of a reduced dose combined with chemotherapy. The less costly and time saving combined treatment was better tolerated than irradiation alone. Histological tumour type did not influence the prognosis in these advanced cases where spread was found outside the true pelvis.

Clinical Trials as Topic↗
PubMed1977

Preoperative irradiation in stage III carcinoma of the ovary.

A series of 456 patients with malignant epithelial tumours of the ovary clinical stage III is presented. Of these, 96 were initially inoperable, and 49 had a clinical diagnosis of inoperable disease at the first examination. After 3000 rads external highvoltage irradiation it was found possible to remove the primary tumour, the uterus and the omentum in 36 (38%) of the previously inoperable patients. Of the 49 patients who had only a clinical diagnosis of inoperability, only four were inoperable at laparotomy performed three weeks after completion of 3000 rads external radiotherapy. The five year survival rate for the whole series was 16%.

Female↗
PubMed1976

Long-term followup of 1121 cases of carcinoma in situ.

A series of 1121 patients with carcinoma in situ have been followed for 5 to 25 years. Recurrences of in situ lesions and development of invasive cancer wwere found, often many years after treatment. Thereapeutic conization was performed in 795 patients, of which 19 (2.3%) had recurrent carcinoma in situ and 7 patients (0.9%) developed invasive cancer. The corresponding figures for 238 patients treated with hysterectomy were, respectively, 3 (1.2%) and 5 (2.1%). The invasive lesions appeared after treatment several years later than the in situ lesions. It is stressed that women having once had in situ carcinoma of the cervix will always be at some risk, and therefore should be carefully followed for a much longer time than the conventional 5 years. Of 42 cases of preinvasive carcinoma extending to the border of the surgical specimen in which conization was performed, 25 were not immediately treated but only observed. Four of these patients developed recurrence from 2 to 6 years after treatment, while 21 are well after a followup period of between 5 and 15 years.

Adult↗