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Biomedical subjects

S C Ballon

Publications and source records attributed to S C Ballon.

At least 37 records · Page 2Linked to original sources
PubMed1985

Cisplatin, doxorubicin, and cyclophosphamide chemotherapy for advanced endometrial carcinoma.

Nine of 19 patients (47%) with widespread or recurrent endometrial carcinoma responded to chemotherapy with cisplatin, doxorubicin, and cyclophosphamide. Two complete clinical responses and seven partial responses were achieved. A "second-look" laparotomy documented the complete response in one patient. The addition of cisplatin to doxorubicin and cyclophosphamide increased toxicity without increasing the antitumor activity previously reported for the two-drug combination. Performance status had a marked influence on response, while sites of metastases, amount of residual disease, and histologic grade did not affect the response rate. A schema for the treatment of patients with endometrial carcinoma with progestins and/or cytotoxic chemotherapy is suggested.

Aged↗
PubMed1984

Partial hydatidiform mole with diploid karyotype: report of three cases.

Recent studies suggest that a partial mole with a triploid karyotype has little tendency to invade and metastasize and usually requires no therapy other than evacuation. This report describes three patients with a mole of normal diploid karyotype coexisting with a living fetus. Each patient had persistent elevation of human chorionic gonadotropin. Two patients required chemotherapy; one of these had invasive mole. The partial mole with normal diploid karyotype is a distinct clinical entity with the potential for malignant sequelae. The possibility of twin gestation cannot be excluded.

Adult↗
PubMed1984

Quantitative human chorionic gonadotropin analysis. I. Comparison of an immunoradiometric assay and a radioimmunoassay.

An immunoradiometric assay (IRMA) for the quantitative analysis of human chorionic gonadotropin (hCG) was evaluated for specificity, sensitivity, accuracy and precision. The results were compared with those of the conventional radioimmunoassay (RIA) used in our laboratory. The IRMA is a solid-phase, double-antibody immunoassay that sandwiches the intact hCG molecule between the two antibodies. It has specificity, accuracy, and precision which are similar to those of the RIA. The RIA is based upon the assumptions that the antigenicity of the tracer is not altered by the iodination process and that the antibody reacts equally with all of the antigens, including the radiolabeled antigen. The IRMA does not use radiolabeled antigens and thus is free of the assumptions made in the conventional RIA. The IRMA may be more accurate at the lower limits of the assay because it does not require logarithmic transformations. Since the IRMA does not measure the free beta-subunit of hCG, it cannot be endorsed as the sole technique to quantitate hCG in patients with gestational trophoblastic neoplasia until the significance of the free beta-subunit in these patients is determined.

Antibodies, Monoclonal↗
PubMed1984

The current status of drug development of hypoxic cell radiosensitizers and their potential role in gynecologic oncology.

Both laboratory and clinical data suggest that hypoxia contributes to the failure of radiotherapy to achieve local control of bulky gynecologic tumors. As part of a Phase I trial of hypoxic cell radiosensitizers, 19 women at Stanford University with advanced (n = 6) or recurrent (n = 13) pelvic neoplasms were treated with radiotherapy plus desmethylmisonidazole. Complete or partial response occurred in 42% of patients with some patients achieving local control for over 1 year. It is unknown if the sensitizer added to the results of radiotherapy alone. A Phase I trial of a theoretically superior sensitizer, SR-2508, is soon to begin. It is anticipated that the dose-limiting neurotoxicity seen with misonidazole and desmethylmisonidazole will either be eliminated or will occur at a much higher total dose of drug. Many patients with gynecologic tumors could potentially benefit from participation in the new drug trials.

Adult↗
PubMed1984

Second-look laparotomy in epithelial ovarian carcinoma: precise definition, sensitivity, and specificity of the operative procedure.

Twenty-five women treated with chemotherapy for epithelial ovarian carcinoma underwent "second-look" laparotomy after thorough clinical and radiographic examinations failed to detect residual tumor. Chest roentgenogram, barium enema, upper gastrointestinal series with small-bowel follow through, and abdominopelvic CAT scan were obtained in all patients prior to operation. Inspection, palpation, and multiple biopsies were performed in accordance with precise and detailed protocol requirements. Eight patients (32%) had gross tumor found at laparotomy, while 6 (24%) had no suspicion of residual disease at operation but had cytologic or microscopic evidence of tumor found on review of submitted specimens. Eleven patients (44%) had no gross or microscopic evidence of residual ovarian carcinoma. After follow-up of from 4 to 25 months, 1 of these 11 patients (9%) has suffered a recurrence. The maximum sensitivity of "second-look" laparotomy is 85.7%, and the maximum specificity is 90.9% in this series. Any additional recurrences observed over time will decrease both the sensitivity and specificity of the operation. The sites of microscopic disease support rigid adherence to a precise operative procedure which should minimize the false negative rate.

Carcinoma↗
PubMed1984

Outpatient use of the feeding jejunostomy catheter.

Selected cancer patients can benefit from home use of the jejunostomy catheter. The indications for this technique include chronic inability to meet basal fluid and caloric needs and risk of intestinal obstruction. This report describes the extended use of the jejunostomy catheter in 20 women with gynecologic malignancies and discusses the benefits and risks of this technique.

Ambulatory Care↗
PubMed1983

Monoclonal versus polyclonal antibody radioimmunoassay against the beta-subunit of human chorionic gonadotropin in patients with gestational trophoblastic neoplasia.

The level of human chorionic gonadotropin (hCG) in series of sera from eight patients with gestational trophoblastic neoplasia was measured by monoclonal antibody and polyclonal antibody radioimmunoassay. A comparative analysis was performed. Three commercially available monoclonal anti-beta-subunit of hCG (beta-hCG) antibodies were evaluated and the most specific and sensitive one was chosen to develop a quantitative beta-hCG radioimmunoassay. beta-hCG radioimmunoassay kits from Nuclear Medical Systems, Inc., and Clinical Assays served as polyclonal antibody assays. Results obtained with the monoclonal antibody radioimmunoassays demonstrated a high degree of correlation (r greater than 0.95, p less than 0.01) with those obtained by the polyclonal antibody techniques; however, the sera from one patient continuously demonstrated a low level of hCG in the monoclonal antibody radioimmunoassay while registering undetectable levels in the polyclonal antibody assays. Although the monoclonal antibody radioimmunoassay appears to be specific and fairly sensitive, the results indicate that, with current technology, there is no special advantage to employing this assay to measure hCG in patients with gestational trophoblastic neoplasia.

Antibodies↗
PubMed1983

Combination cisplatin, vinblastine, and bleomycin chemotherapy (PVB) for malignant germ-cell tumors of the ovary.

Nine women with germ-cell tumors of the ovary (three endodermal sinus tumors, four immature teratomas, and two mixed germ-cell tumors) were treated with cisplatin, vinblastine, and bleomycin (PVB) chemotherapy after cytoreductive operations. Five patients were stage I, three were stage III, and one patient had recurrent disease. All nine women are alive and without evidence of disease with a median follow-up of 31 months from diagnosis and 27 months since completion of PVB. Treatment toxicity although occasionally severe was rapidly reversible.

Adult↗
PubMed1982

Positive peritoneal cytology in corpus carcinoma. Report of a fatal outcome.

A 64-year-old patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy in October, 1978 for a Stage IA, grade 2 papillary adenocarcinoma of the endometrium. Peritoneal washings contained numerous malignant cells, although the tumor invaded the myometrium only superficially. Two weeks after operation, 12 mCi of P32 were instilled into the peritoneal cavity. In May, 1979, laparotomy was performed for clinical obstruction of the small intestine and revealed diffuse peritoneal, omental, and hepatic metastases. Radiation changes involved the terminal ileum, ascending and sigmoid colon; an ileorectal fistula was also identified. The factors that might cause malignant cells to be present in the peritoneal cavity and the ideal treatment of such patients have yet to be determined. THe risk of intraperitoneal P32 might outweigh its benefits.

Adenocarcinoma, Papillary↗
PubMed1981

Intestinal operations in patients with ovarian carcinoma.

Forty-two patients with epithelial ovarian carcinoma underwent intestinal operations at the University of California, Los Angeles, and the City of Hope National Medical Center during the course of the disease. The patients were divided into three groups for purposes of this analysis. The first group had intestinal surgery during their initial laparotomy. Patients in the second group underwent intestinal operation at the time of re-exploration for recurrent disease but had no preoperative signs or symptoms of intestinal tract dysfunction, while those in the third group underwent re-exploration for symptomatic intestinal involvement by tumor. Operative complications, postoperative morbidity, and effect of the resection on disease outcome are analyzed for each group in an attempt to define the indications for intestinal resection or bypass in patients with epithelial ovarian cancer.

Colostomy↗
PubMed1981

Survival after extraperitoneal pelvic and paraaortic lymphadenectomy and radiation therapy in cervical carcinoma.

Clinical staging, bipedal lymphangiography, and extraperitoneal pelvic and paraaortic lymphadenectomy were performed in 95 patients with invasive squamous carcinoma of the cervix. Radiation therapy was modified on the basis of findings at operative staging. Patients have been followed from 16 to 91 months, with a mean of 41 months. The accuracy of clinical staging and the relative abilities of lymphangiography and lymphadenectomy to assess the retroperitoneal lymph nodes have been determined. Five-year survival with respect to stage of disease and status of the pelvic and paraaortic lymph nodes was calculated by the life-table method. Seventy-five percent of patients with no lymph node metastases are projected to be alive at 5 years without recurrence. Fifty-six percent with pelvic lymph node metastases and 23% of those with paraaortic lymph node involvement are projected to be free of disease at 5 years. The risk of lymph node metastases increases with either the stage of disease or the volume of the primary tumor independently of stage. The presence of lymph node metastases adversely affects survival regardless of the stage of the primary tumor. Clinical staging as accepted by FIGO is inadequate in that it ignores patients with pelvic or paraaortic lymph node metastases. The accuracy of detection in the individual patient does not increase with the addition of lymphangiography. Operative staging can be performed safely by the extraperitoneal route and radiation therapy can be modified on the basis of the true extent of disease. Radiation therapy fails to cure patients because of distant dissemination of disease as well as an inability of conventional radiotherapeutic techniques to sterilize a large primary tumor volume.

Female↗
PubMed1980

Serum androgens and estrogens in postmenopausal women with and without endometrial cancer.

Thirty-five consecutive patients with adenocarcinoma of the endometrium and an equal number of control subjects matched to the cancer patients for age and percentage of ideal weight were studied prospectively. In the cancer patients, the mean +/- SE serum androstenedione, testosterone, estrone (E1) and estradiol (E2) levels were 503 +/- 34 pg/ml, 224 +/- 22 pg/ml, 38.7 +/- 3.6 pg/ml, and 14.5 +/- 0.9 pg/ml, respectively. Similar concentrations were found in the control subjects. Body weight and percentage of ideal weight showed highly significant correlations (P less than 0.001) with E1 and E2 but not with the androgen concentrations in either group. The heavier patients had higher E1 and E2 levels. Age and years since menopause did not correlate with any of the hormonal levels. The cancer patients with overt diabetes tended to be more obese and have higher estrogen levels than did the nondiabetic subjects. Those with a history of prior estrogen usage were more slender and had lower endogenous estrogens than the nonusers. Twenty-three of the cancer patients (66%) had a presumed risk factor(s) for the development of this tumor, that is, excess body weight, high endogenous estrogen levels, or a history of prior estrogen usage. These data support the concept that conditions which lead to continued, unopposed estrogen stimulation may be associated with malignant transformation of the endometrium.

Adenocarcinoma↗
PubMed1980

Prognosis and treatment of endometrial cancer.

An understanding of the patterns of spread and prognostic factors influencing survival is necessary to develop rational treatment programs for patients with endometrial cancer. The most important risk factors include the stage of tumor, status of pelvic lymph nodes, depth of myometrial penetration, tumor grade, cell type, and patient age. Because of the inherent inaccuracies of staging based on pelvic examination and the inability to assess the status of lymph nodes or myometrial penetration clinically, errors in management often result when radiation therapy is delivered prior to operation. Therefore, a rationale is offered for primary operative management of patients with Stage I disease, with consideration of adjunctive radiation therapy following operation based on extend of disease and a thorough evaluation of the high-risk factors. It is suggested that patients with more advanced stages of disease be considered for pretreatment operative evaluation. Data are presented which refute theoretical objections to this approach.

Adenocarcinoma↗