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P Ogreid

Publications and source records attributed to P Ogreid.

At least 19 recordsLinked to original sources

[Normal tissue radiation toxicity in radiotherapy of localized prostatic cancer].

Radical radiotherapy of prostate cancer has to balance tumour control against the risk of radiation injury of normal tissue. The normal tissue toxicity is the main dose-limiting factor, and consequently a limiting factor of the curative potential of prostate cancer by irradiation. The SOMA scale is a new toxicity scoring system that registers late side effects from the most important anatomical sites. The SOMA scale is internationally approved and facilitates a standardised evaluation of radiation toxicity. The scoring system is based on four main components: subjective, objective, management and analysis. The SOMA scoring system was applied to a group of 21 patients from Ullevaal Hospital who were given intentionally curative radiation therapy for localised prostate cancer. The SOMA scale scoring system appears to be a valuable tool in the evaluation of normal tissue toxicity. It may contribute to a new standard in quality assurance of radiation therapy of prostate cancer.

Aged↗

Tissue prostate-specific antigen and androgen receptor immunoreactivity in prostate cancer biopsies before, during and after neo-adjuvant androgen deprivation followed by radiotherapy.

OBJECTIVE: The purpose of the study was to examine the immunohistochemical stainability of prostate-specific antigen (PSA) and androgen receptor (AR) in biopsies from localised prostate cancers before treatment, after androgen deprivation and after radiation therapy. PATIENTS AND METHODS: Biopsies were taken from 16 men with prostate cancer (T1-3,Nx,M0) before the start (START) of androgen deprivation with LHRH analogue, during the following pelvic lymph node dissection (PLND), and twice after radiotherapy (POSTRAD and FINAL). RESULTS: Malignant cells were observed in all START, PLND and POSTRAD biopsies and in 6 of 7 FINAL specimens. During androgen suppression and subsequent radiotherapy a gradual reduction in tissue immunoreactivity for PSA and AR was observed paralleled by a reduction in serum PSA. The most striking observation was the complete lack of AR stainability after combined LHRH/radiation therapy. Of the 7 patients who had a long-term follow-up after radiotherapy, 1 patient was cancer negative on biopsy and without AR and PSA stainability. Six patients with cancer-positive FINAL biopsies had regained AR stainability. Five of these latter biopsies also stained for PSA. Five of the six patients had no elevation in serum PSA. CONCLUSION: After combined hormone/radiotherapy serum PSA is a relatively unreliable marker for the demonstration of residual cancer. This combination therapy leads to transient loss of immunohistochemically stained tissue PSA and AR in the residual cancer.

Aged↗

[Urogenital tuberculosis].

Urogenital tuberculosis has unspecific clinical symptomatology. This is often a result of the complications of the disease. Clinical symptoms, X-ray examinations, urinary microscopy, cultures and cytological and histological examinations may reveal the diagnosis. Initial treatment is medical therapy, but surgery will often be a necessary supplement. Follow-up during the treatment period is important to avoid unnecessary complications. With appropriate treatment and follow-up, the prognosis will be good.

Aged↗

Epirubicin combined with estramustine phosphate in hormone-resistant prostate cancer: a phase II study.

Twenty-four assessable patients with hormone-resistant prostate cancer (HRPC) were to receive daily doses of oral estramustine phosphate (EMP), 10 mg kg(-1), and intravenous epirubicin (EPR) infusions, 100 mg m(-2), every third week up to a cumulative dose of 500 mg m(-2). Biochemical response [> or = 50% reduction in pretreatment serum prostate-specific antigen (PSA) after three cycles of > or = 3 weeks' duration] was demonstrated in 13 of 24 patients included (54%). No objective response (WHO criteria) was observed, although seven of nine evaluable patients achieved a > or = 50% serum PSA reduction. Subjective improvement (pain score, performance status) occurred in 7 of 24 patients, whereas nine patients progressed subjectively. There was no correlation between subjective and biochemical response. Biochemical progression (> or = 50% increase of nadir PSA) occurred after a median of 12 weeks. All but two patients were alive after a median follow-up time of 8.7 months for surviving patients (range 3.3-13.2). Eight patients experienced grade 3/4 leucopenia, with no indication of cumulative myelosuppression. Cardiovascular toxicity was experienced by four patients. Two patients developed angioedema twice, in one patient requiring hospitalization at the intensive ward. Based on this limited series, the combination of EPR and EMP in patients with HRPC is tolerable and appears to be effective in terms of significant PSA reduction. The results warrant further investigations of the two drugs and, in particular, of the clinical significance of > or = 50% PSA decrease in patients with HRPC.

Antineoplastic Combined Chemotherapy Protocols↗

[Laser treatment of benign prostatic hyperplasia].

Transurethral resection of the prostate (TURP) has been the gold standard for BPH for over 50 years. For the last five years laser treatment of BPH has been developed as a new modality. The principles of laser surgery and the options available in clinical practice today are outlined. A survey of indications, patient selection, results and complications are given based on the authors' own experience and reports from the international literature.

Anesthesia, Local↗

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↗

A bladder cancer multi-institutional experience with total cystectomy for muscle-invasive bladder cancer.

BACKGROUND: The role of total cystectomy was to be assessed in the curative treatment of muscle-invasive bladder cancer. METHODS: Two hundred and fifty-three patients with T2-T4a transitional cell carcinoma of the urinary bladder were referred to precystectomy radiation therapy (46 Gy, 66 patients; 20 Gy, 187 patients). These patients represented approximately 20% of all patients developing muscle-invasive bladder cancer in Southern Norway from 1980-1990. The clinical T categorization was generally based on palpability and extent of the palpable bladder tumor assessed by the referring urologist. Twenty-six patients (10%) did not have total cystectomy, most often due to peroperatively demonstrated locoregional inoperability. Two or three cycles of cisplatin-based combination chemotherapy were given to 68 patients. RESULTS: For the 227 patients who underwent cystectomy, the cancer-specific 5-year survival rate was 58% (T2 [104 patients], 63%; greater than or equal to T3 [123 patients], 54%) (P = 0.022). The comparable figure for patients with histologically proven regional lymph node metastases was 22%. The 97 stage-reduced cases (less than or equal to pT1) survived significantly longer than the 130 patients without stage reduction (74% versus 46%) (P < 0.0001). Neoadjuvant chemotherapy was correlated with a more favorable survival in patients with greater than or equal to T3 tumors but did not seem to influence survival of patients with T2 bladder cancer. CONCLUSIONS: In a multicenter setting, prognostically relevant T categorization of operable muscle-infiltrating bladder cancer can be based on the palpability of the primary tumor. Approximately 50% of favorably selected patients with operable T2-T4 bladder cancer survived for at least 5 years independent of whether the operation was done at a large uro-oncologic unit or a smaller urologic section. In this retrospective review, chemotherapy seemed to improve the survival in patients with deeply infiltrating (greater than or equal to T3) bladder cancer but appeared to represent an overtreatment in patients with T2 tumors.

Adult↗

Clinical significance of DNA ploidy and S-phase fraction and their relation to p53 protein, c-erbB-2 protein and HCG in operable muscle-invasive bladder cancer.

DNA ploidy and S-phase fraction (SPF), determined by flow cytometry were studied in 118 patients with muscle-invasive transitional cell carcinoma (TCC) of the urinary bladder, scheduled for cystectomy after pre-operative radiotherapy (20 Gy/1 week) with or without systemic cisplatin-based neo-adjuvant chemotherapy. The correlation between these parameters and immunohistochemically demonstrated p53, c-erbB-2 and HCG was also investigated. There were 16 DNA diploid and 102 DNA non-diploid tumours. DNA ploidy was not related to the T (all 118 patients) or pN (58 patients) category, occurrence of stage reduction or cancer-related 5 years survival. Patients with high SPF tumours tended, however, to have a better prognosis than those with low SPF TCC reaching the level of significance (P < 0.05) for those patients who had high SPF tumours and received neo-adjuvant chemotherapy. Fifty-one of the tumours were p53 positive. p53 positive tumours were significantly more often found in TCC with low SPFs than in those with high SPFs. Respectively 12 and 9% of the tumours were HCG and c-erbB-2 positive, without correlation to DNA ploidy or SPF. We conclude that DNA ploidy does not represent a prognostic parameter in muscle-invasive operable bladder carcinomas. A high SPF, determined by FCM, may be helpful to identify patients with chemotherapy-sensitive TCC of the urinary bladder.

Adult↗

[Synchronous bilateral testicular cancer with different histologies].

Synchronous appearance of bilateral testicular germ cell tumours is a rare clinicopathologic entity. The incidence is estimated to be approximately 1% of all testicular tumours. Synchronous cases of different cell types on each side are extremely uncommon. Until 1987 only seven such patients were reported. We describe an additional case and discuss the diagnostic approach.

Adult↗

Testicular histology after treatment with LH-RH analogue for carcinoma of the prostate.

Orchiectomy was performed in 16 patients because of progression of prostatic cancer despite adequate medical castration with goserelin (Zoladex, ICI) over a mean period of 17.6 months. Severe tubular atrophy was seen in the testes. The Leydig cells also showed signs of atrophy, a fact that may indicate a direct effect of goserelin on these cells. In 1 patient, however, orchiectomy was postponed for 3 months after cessation of medical castration. The serum testosterone had resumed almost normal values and testicular histology revealed intact spermatogenesis and apparently normal Leydig cells.

Aged↗

Digital rectal examination to screen for prostatic cancer.

In a prospectively designed study 480 men, aged 45-67 years of age having routine medical examinations as part of the Occupational Health Service Program, underwent digital rectal examination to screen for early prostatic cancer. 26 men were referred to the Urology Service of the Aust-Agder Central Hospital for repeat examinations and further diagnostic procedures. Biopsies were performed on 16 patients, and transrectal ultrasound examination on 9. One patient was found to have prostate cancer. The value of an organized screening program for the detection of early prostatic cancer still seems to be under discussion.

Aged↗

Noninvasive evaluation of the enlarged prostate preliminary results.

The choice between a conventional endoscopic examination of the prostate and a noninvasive technique with ultrasound raises a basic question: Which method is most reliable and informative yet has an acceptable costbenefit ratio? One hundred patients selected on the basis of fixed criteria were examined by ultrasonography and so far 50 have been operated on. Pathologic conditions were observed in the upper urinary tract at ultrasonography in 18% of the cases. The method was found reliable as a basis for the choice between open prostatectomy and transurethral resection. Noninvasive examination of patients with an enlarged prostate is a reliable method in the preoperative evaluation. The method is convenient to the patient and no more time-consuming than cystoscopy. The capital investment in ultrasound is high, but the cost per examination low.

Aged↗

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↗

High-dose medroxyprogesterone acetate versus prednisolone in hormone-resistant prostatic cancer. A pilot study.

Medroxyprogesterone acetate (MPA) (1,000 mg daily per os) yielded (mainly subjective) remissions in 8 of 21 patients with hormone-resistant cancer of the prostate. In 24 comparable patients, treated with prednisolone (20 mg daily per os) 3 remissions were observed, indicating a slight superiority of high-dose MPA considering the response rate. The response duration for both drugs was relatively short (2-7 months). No survival benefit for either drug was observed. In patients with hormone-resistant cancer of the prostate, a significant improvement of the performance status should be registrated as subjective response. This is a major aim of any treatment in these patients. Normalization of serum acid phosphatase may also be considered as remission. The type of remission (greater than 50% reduction of measurable tumor lesions, reduction of serum acid phosphatase, subjective remission) should always be indicated in the individual report dealing with phase II/phase III studies in patients with hormone-resistant prostatic cancer.

Acid Phosphatase↗