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Biomedical subjects

P R Olsen

Publications and source records attributed to P R Olsen.

At least 19 recordsLinked to original sources
PubMed2002

Long term follow-up of superficial invasive bladder carcinoma with or without concomitant epithelial atypia--recurrence and progression.

OBJECTIVE: To examine the significance of concomitant epithelial atypia on late recurrence and progression by long-term follow-up of superficial invasive bladder tumours (stage T1). MATERIAL AND METHODS: Seventy consecutive, unselected patients with newly diagnosed transurethral resection (TURB)-treated stage T1 bladder tumour, and at least 1 year progression-free survival. Preselected site biopsies (PSB) were obtained prospectively to evaluate the significance of concomitant urothelial atypia. Followed for up to 17.6 years. RESULTS: The cumulative probability of recurrence (overall) was 85%, and for new stage T1 tumour 70% after 10 years. Forty per cent of those who survived 5 years without recurrence, were readmitted with often invasive recurrence later. Positive PSB significantly (p < 0.0001) predicted new T1 tumour. Progression (T2+ or metastases) occurred in 27 cases (39%) after the first year. The cumulative probability was 60% (15 years), with a mean progression-free interval of 64 months. Positive PSB, size >3 cm and early recurrence were significant predictive factors in multivariate analysis. CONCLUSION: T1-tumours are at high risk for late invasive recurrence and progression, especially if associated with urothelial atypia elsewhere in the bladder.

Adult↗
PubMed2000

Long-term follow-up of noninvasive bladder tumours (stage Ta): recurrence and progression.

OBJECTIVE: To evaluate long-term recurrence-free and progression-free survival of noninvasive bladder tumours (stage Ta), and the significance of simple risk factors, including concomitant epithelial dysplasia. PATIENTS AND METHODS: The study included 217 patients with primary noninvasive bladder tumour (stage Ta) who were followed routinely for up to 20 years. Voided urine cytology (VUC) and preselected site biopsies (PSB) were obtained prospectively to evaluate the significance of concomitant epithelial dysplasia. RESULTS: The mean follow-up was 84 months (maximum 238). Of all tumours, 39% did not relapse, a further 20% recurred infrequently (less than once a year) and 41% recurred frequently, amongst which the most frequent were multiple and early recurrent tumours; 42 (19%) tumours progressed to stage T1+ and 23 (11%) progressed further (stage T2+ or metastases). No grade 1 tumours became invasive. Positive VUC or PSB, a short recurrence-free period or multiplicity, and size > 3 cm were significant predictive factors. The treatment and surveillance of epithelium-confined bladder tumours are discussed. CONCLUSION: Concomitant dysplasia and early recurrence are associated with considerable risk of progression in the long-term follow-up in a group of otherwise low-risk superficial bladder tumours (stage Ta).

Adult↗
PubMed1998

Long-term survival of patients with bladder tumours: the significance of risk factors.

OBJECTIVE: To evaluate the significance of known risk factors, accessible by simple endoscopic and histological/cytological examination, on the clinical course and long-term survival of patients with superficial urinary bladder tumours. PATIENTS AND METHODS: The study included 584 consecutive unselected patients, primarily admitted between 1976 and 1984 for newly diagnosed bladder tumour, which was superficial (Ta, T1, Tis) in 362. The patients were followed routinely in a control programme; causes of death were obtained by autopsy (44%), from hospital files (33%) or from death certificates (8%), the remaining patients being alive at the end of the study, up to 20 years after initial diagnosis. Known risk factors, e.g. tumour size, histological grade, multiplicity and positive urine cytology, and dysplasia as assessed by random or pre-selected site biopsies, were evaluated as predetermining factors for new occurrences and survival. RESULTS: Invasion of the lamina propria was the most significant prognostic factor detected in the multivariate analysis. While 14% of patients with Ta tumours had died from cancer after 15 years, 63% of the T1 tumours were eventually fatal, reaching the mortality of those with T2 disease. Other independent significant factors were tumour size and, to a lesser extent, histological grade. Multiplicity and concomitant epithelial changes, as assayed by voided urine cytology and pre-selected site biopsies, were relevant prognostic factors for Ta but not for T1 tumours. CONCLUSION: In the therapy and surveillance of superficial urinary bladder tumours, the presence of lamina propria invasion is very important.

Adult↗
PubMed1998

Risk of haemorrhage from transurethral prostatectomy in acetylsalicylic acid and NSAID-treated patients.

Postoperative bleeding in patients who regularly ingest acetylsalicylic acid (ASA) has been reported after several types of surgery. However, data on the influence of ASA on the risk of haemorrhage from transurethral prostatectomy (TUR-P) have been conflicting. We have studied retrospectively the unselected clinical records of all patients undergoing TUR-P in the Department of Urology at Hvidovre Hospital (during 1992-1994) with special focus on the use of ASA and non-steroidal anti-inflammatory drugs (NSAIDs). In total, 457 records were examined: 99 patients on ASA/NSAID received 42 units of blood, while 358 patients free from such medication received 68 units of blood, a significantly smaller amount (p = 0.0390). We conclude that ASA and NSAIDs increase the risk of bleeding during and after TUR-P, and we recommend the withdrawal of these drugs for one week before TUR-P.

Aged↗
PubMed1996

[The open, interdisciplinary incontinence clinic at Hvidovre Hospital. Preliminary experiences from the first 16 months].

A "minimal care" program for examination and treatment of urinary incontinence in an open access incontinence clinic was assessed. The first 300 women and 27 men consecutively investigated in the clinic are described. A reference program based on minimal relevant work-up and non-operative treatment as first line with use of minimal resources was followed. Of 171 evaluated women, 100 received non-operative treatment besides general advice on voiding/toilet pattern and appropriate incontinence appliances. Subjectively 69% felt cured or very much improved, 25% experienced improvement while 6% did not report benefit of the treatment. Objectively, diminished leakage was demonstrated by pad-weighing test. Similar results were found in the treated men. Our preliminary results demonstrate, that an open access, interdisciplinary clinic is patient-accepted and effective for the evaluation and treatment of urinary incontinence.

Adolescent↗
PubMed1994

[Impotence and corpus cavernosum leakage. Results after surgical treatment].

A consecutive series of 15 impotent men (mean age: 53 (range 18-65 years)) underwent venous surgery for abnormal drainage of the cavernous bodies. During the follow-up period (mean 19 months (range 10-34)), 11 patients became potent and sexually active. Three of the impotent men had had a primary venous leakage of the corpora cavernosum, and all these three had to be re-operated. Two achieved full potency. The three postoperative failures in the 12 patients with the secondary type of venous impotence occurred in one heavy smoker, one patient with severe arterial hypertension and one continued to be impotent until his death eight months postoperatively. It is concluded that erectile impotence due to pronounced leakage of the cavernous bodies should be treated surgically, and that the longterm effect is acceptable.

Adult↗
PubMed1989

[Laser treatment of penile cancer].

The treatment of localized penile cancer has hitherto been surgical amputation of the penis. In our 12 cases, tumorectomy was performed by CO2 or ND:YAG-laser radiation with minimal tissue ablation. Local recurrences occurred and the patients must be followed regularly in the outpatient clinic. The recurrences were treated by repeated laser radiation. No patients died of penile cancer during a mean observation of 16 months (range 3-50). Laser tumorectomy has definitive therapeutic advantages compared with penile amputation, because the result is acceptable for the patient and his micturition and sexual life are not altered.

Adult↗
PubMed1987

Urothelial atypia concomitant with primary bladder tumour. Incidence in a consecutive series of 500 unselected patients.

A consecutive series of 500 primary bladder tumours from a single clinic is presented, with distribution of the tumours according to T category and histologic type and grade. Mucosal biopsies were obtained from pre-selected sites at initial cystoscopy or initial transurethral resection of the tumour in 396 cases. In 54% of the patients with grade III tumour there was concomitant urothelial atypia, either carcinoma in situ (urothelial atypia grade III, 30%) or urothelial atypia grade II (24%). In 30% of the patients with invasive grade II bladder tumour and in 14% of those with noninvasive grade II tumour there was concomitant urothelial atypia, mostly grade II. Since concomitant urothelial atypia predicts new tumour growth after successful transurethral surgery or radiotherapy, mucosal biopsies should be performed at preselected sites during initial cystoscopy or transurethral tumour resection in order to identify high-risk patients.

Adenocarcinoma↗
PubMed1985

Urothelial dysplasia concomitant with bladder tumours: a determinant for future new occurrences in patients treated by full-course radiotherapy.

Concomitant urothelial dysplasia has been shown to predict new tumour occurrences after successful transurethral surgery of primary invasive bladder tumours. Of 114 patients with invasive bladder tumours treated by radiotherapy alone, 32 patients had complete primary tumour response and mucosal biopsies taken at preselected sites during initial cystoscopy. 10 of these patients had concomitant carcinoma-in-situ; in 7 new invasive tumours occurred 9-24 months after completion of radiotherapy. 4 of 9 patients with concomitant dysplasia grade-II also showed new invasive tumour growth. No new tumours developed in 13 patients without concomitant urothelial dysplasia who were followed for 9-75 months. Thus, the presence of concomitant carcinoma-in-situ in patients treated by radiotherapy predicts new invasive tumour growth, whereas its absence favours a very good prognosis. Patients with carcinoma-in-situ concomitant with invasive bladder tumours are not suitable for full-course radiotherapy as the only treatment.

Carcinoma in Situ↗
PubMed1985

Total colectomy, mucosal proctectomy, and an ileal reservoir to an anal anastomosis. A comparison of short and long efferent legs.

In a consecutive series of 46 possible candidates for total colectomy, mucosal proctectomy, and ileal reservoir to an anal anastomosis, we have compared the clinical outcome of group I, with a long efferent leg (12 cm), and group II, with a short efferent leg (3-5 cm). The surgical procedure was done in three steps: first, a total colectomy; second, mucosal proctectomy and construction of an 'S-shaped' ileal reservoir with a temporary loop ileostomy; and, third, closing of the ileostomy. Nine patients with a long efferent leg and eight patients with a short leg were observed for 2-51 months with a functioning ileal reservoir. The overall mortality was zero. The results showed that the short efferent leg was important for low fecal urgency, spontaneous evacuation of stools, minimal soiling, independence of reservoir catheterization, and use of antidiarrheal drugs. The length of the efferent leg did not influence the function of the anal sphincter itself. The postoperative sexual life was unchanged, and all patients in group II had a better resocialization than those in group I. The selection of candidates for ileal reservoir operations from among patients with ulcerative colitis or familiar polyposis is most important because of a relatively long postoperative course and high incidence of surgical complications.

Adolescent↗
PubMed1984

Administration of a retinoid as prophylaxis of recurrent non-invasive bladder tumors.

A controlled study has been conducted to ascertain whether administration for 8 months of a vitamin A-acid analog, Tigason, could prevent recurrences of non-invasive bladder tumors. Eligible were 73 patients, 33 in the Tigason group, and 40 in the placebo group. The results indicate that Tigason, as used in this study, is ineffective as prophylaxis. Side effects to Tigason urged 17 patients to drop out from the study mostly due to symptoms from skin and mucous membranes. The discussion considers different reasons for the lack of effect and concludes that more tolerable vitamin A-acid analogs are needed if further studies of prevention of non-invasive bladder tumors are to be carried out.

Antineoplastic Agents↗