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Biomedical subjects

T Urnes

Publications and source records attributed to T Urnes.

17 recordsLinked to original sources
PubMed1996

Diagnosis and treatment of enterovesical fistula.

The records of 24 patients with enterovesical fistula treated at the urology sections of Telemark and Vestfold Central Hospitals are presented. Most fistulas were due to diverticulitis or a malignant tumor. The part of the intestine most frequently affected was the sigmoid colon in 14 patients, the rectum in 3, the cecum in 2 and the small intestine in 2. Of the 21 patients operated on, 12 underwent a one-stage procedure with resection of the fistula and primary anastomosis of the intestine. The postoperative course was uneventful for 16 patients. Recurrence of the fistula occurred in 1 patient. Three patients were conservatively treated. We recommend a one-stage operation for patients in a good general operating condition, with a well-organized fistula and no systemic infection.

Adult↗
PubMed1993

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↗
PubMed1993

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↗
PubMed1990

A randomized study on hormone-resistant prostatic cancer: estramustine phosphate versus low dose epirubicin with or without medroxyprogesterone acetate. A Norwegian multicenter study.

A prospective randomized study has been carried out in order to compare three different treatment modalities for symptomatic metastatic hormone-resistant prostatic cancer. A total of 79 patients were included. One group was treated with estramustine phosphate, another with Epirubicin plus Medroxyprogesterone acetate (MPA), while the third arm consisted of Epirubicin plus placebo. Best palliation was obtained by the combination of Epirubicin and MPA. This combination also seemed to be associated with the longest response duration.

Administration, Oral↗
PubMed1987

Weekly low-dose adriamycin in hormone-resistant metastatic cancer of the prostate.

Weekly intravenous doses of 20 mg Adriamycin were given to 22 patients with hormone-resistant metastatic cancer of the prostate. (Median duration treatment: 8 weeks; range 3-60 weeks.) Of 21 adequately treated patients, 6 achieved a subjective response (Median duration: 4 weeks; range 4-28 weeks). In 2 patients a more than 50% size reduction of measurable lymph node metastases was observed, while the disease progressed at other sites (mixed response). The median survival from treatment start (8.5 months) was unrelated to the achievement of subjective response. In 10 of 21 patients a reduction of serum alkaline phosphatase was observed and 7 of 21 patients showed a decrease of serum prostatic acid phosphatase. These biochemical changes were not related to response. Toxicity was generally mild, but one case with severe irreversible thrombocytopenia was observed after 3 weekly doses of 20 mg Adriamycin. Weekly low-dose Adriamycin has marginal subjective efficacy in progressing hormone resistant prostatic cancer, a condition where effective and feasible chemotherapy is lacking. The combination of weekly low-dose Adriamycin with other agents, preferably hormones, should be explored.

Aged↗
PubMed1987

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↗
PubMed1987

Cancer of the penis. Experience at the Norwegian Radium Hospital 1974-1985.

The cancer-related 5-year survival was 80% in 79 patients with penile cancer treated at the Norwegian Radium Hospital from 1974 to 1985 (N0 = 61, N1-2 = 12, N3 = 6). Sentinel node biopsy (SLN) of the inguinal lymph nodes medial to the saphenous vein helps to identify patients with early regional spread. The survival for these N+ patients is favourable if radical lymph node dissection is performed immediately. A tumour-negative SLN biopsy does, however, not exclude the subsequent development of inguinal lymph node metastases. These were found equally often during follow-up in patients with or without primary performance of SLN biopsy. Five of 6 patients, relapsing with groin metastases, were cured by secondary lymph node dissection. Most of the small primary tumours (T1/T2) can be treated radically by primary radiotherapy, but frequent follow-up is necessary to detect surgically curable penile recurrences (3 of 11 patients). Combination treatment of chemotherapy, radiotherapy and surgery represents a good palliation treatment in advanced cases.

Adult↗
PubMed1986

Flare reaction during the initial treatment period with medroxyprogesterone acetate in patients with hormone-resistant prostatic cancer.

During the initial period of treatment with high-dose medroxyprogesterone acetate (MPA), 4 of 40 patients with metastatic prostatic carcinoma experienced a marked clinical flare reaction, predominantly with bone pain exacerbation. All 4 patients subsequently had excellent subjective responses to MPA treatment, lasting for several months. The reason for this transient flare reaction is poorly understood but most probably represents a temporary androgenic effect of high-dose MPA on the prostatic cancer cell. The clinician should be aware of the possibility of an initial flare reaction during MPA treatment of advanced prostatic cancer and avoid premature discontinuation of the drug.

Aged↗
PubMed1985

Short-term and long-term effect of prophylactic treatment of superficial bladder cancer with intravesical adriamycin.

37 patients with recurrent Ta/T1 bladder cancer were treated with intravesical adriamycin (80 mg monthly) after complete TUR (1977-1979). Within a minimum follow-up of 5 years, 11 of them developed evidence of progression - muscle invasion or distant metastases. 8 of them have died of bladder cancer. Ten patients showed a complete response to adriamycin therapy, developing no new tumors during the period of treatment (1 year). One of them developed distant metastases. The remaining 27 patients continued to develop recurrences, despite adriamycin therapy, though the recurrence rate was reduced by at least 50% in 5 of them. The risk of progression and death remains high if the patient continues to have recurrences, even in cases in which the recurrence rate is apparently reduced. Recurrent superficial bladder cancer remains a dangerous disease. The prognosis is good if recurrences cease altogether during prophylactic intravesical adriamycin treatment.

Aged↗
PubMed1983

Transurethral resection of bladder tumors under local anesthesia.

More than two thirds of urothelial bladder tumors are of small or intermediate size and of low grade. These lesions are treated mostly with transurethral resection. To reduce trauma to patients and the costs for medical care, we have evaluated if such tumors could be excised using topical anesthesia of the urethra supplemented with infiltration of a local anesthetic into the tumor base and bladder wall. In 104 of 125 resections the patients experienced little or no pain. A new fine-caliber cystourethroresectoscope has greatly facilitated the anesthetic and surgical procedures.

Adult↗
PubMed1979

Crossed, non-fused renal ectopia and ipsilateral ureteral carcinoma. A case report.

A man with crossed, non-fused renal ectopia had carcinoma of the distal ureter, leading to hydro-ureter, hydronephrosis and urinary infection. Crossed ectopic kidneys are more disease-prone than are normal kidneys. Complicating disorders are discussed, the value of thorough urologic investigation is stressed and the incidence of tumour of the upper urinary tract in crossed renal ectopia without fusion is reviewed.

Carcinoma, Transitional Cell↗