摘要:

Forty premenopausal patients with advanced breast cancer entered a prospective and randomized study in which high-dose medroyxprogesterone acetate (HD MAP) and oophorectomy (OPX) were compared. All the patients were first treated for advanced disease. Twenty-two patients received HD MAP (1,000 mg b.i.d. p.o.) and 18 patients received OPX. Complete remission (CR) was achieved in 2 (9%) in the HD MAP group and in 2 (11 %) in the OPX group for a duration of 20–24 and 30–54 months respectively. Partial remission (PR) was achieved in 10 (45%) patients in the HD MAP group and in 4 (22%) patients in the OPX group for a median duration of 9 and 7 months respectively. The objective response rates (CR + PR) were 55% for the HD MAP group and 33% for the OPX group (p = 0.17). Ten patients who received OPX as first-line treatment received HD MAP when the disease progressed and were evaluable for response: PR was achieved in 6 patients (2 responders and 4 nonresponders to OPX) for a median duration of 5 months. Two out of 4 patients who received OPX at progression after objective response to HD MAP presented PR. HD MAP induced a significant decrease in pain intensity and, compared to OPX, a more frequent improvement was induced in performance status. No difference was observed between the two groups in terms of overall survival. This study shows that HD MAP is an active treatment in premenopausal patients with advanced breast cancer and that it can induce a response in some patients resistant to

ISSN:0030-2414    

DOI:10.1159/000226884

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Seventy-two patients with advanced ovarian cancer received CAP chemotherapy followed by laparotomy and ‘second-effort’ surgery. The overall response to CAP therapy was 80%. A complete pathological response (CPR) was obtained in 16 patients and partial microscopic (PMiR) and macroscopic responses in 7 and 33 cases, respectively. The actuarial survival for the entire group was 36% at 50 months with a median survival of 34 months. No significant differences in survival between the CPR and PMiR groups were found. Radical second-effort surgery showed a somewhat beneficial effect. The tumor size before chemotherapy ( < 5 cm) and FIGO stage III had a significantly favorable effect on response rate and survival.

ISSN:0030-2414    

DOI:10.1159/000226885

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The serum levels of immunosuppressive acid protein (IAP) and CA 125 were determined in 98 patients with ovarian cancer, in 20 patients with benign ovarian tumors and in a group of normal postmenopausal women as controls. On the basis of the mean values of normal controls (346.46 ± 133.26 μg/ml), the IAP threshold was fixed at 613 ∣ig/ml. Increased IAP levels were found in 70.4% of patients with ovarian cancer, in 25% of benign tumors and in 4.5% of normal women. Elevated levels of CA 125 were observed in 66.6% of cancers, in 40% of benign tumors and in 6.9% of controls. In particular, in early stage ovarian cancer the combined assay of the two markers increased by about 30% with respect to CA 125 alone. The simultaneous determination of IAP and CA 125 allowed an overall sensitivity of 84% without any significant reduction of specific

ISSN:0030-2414    

DOI:10.1159/000226886

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Continuous venous infusion of 5-fluorouracil (5FU) was investigated in 18 patients with measurable advanced cancer of the pancreas. 5FU was given for 7 days in a dose of 500 mg/m2 by continuous venous infusion over a 24-hour period and then followed by a dose of 170 mg/m2 for more than 28 days. Ten patients had no change including 1 patient with minor response, and 4 patients had disease progression. Serum CA19-9 levels were measured serially after chemotherapy in 13 of 14 evaluable patients. In 3 of 10 patients who showed high levels before treatment, serum CA19-9 levels were significantly decreasing after treatment.

ISSN:0030-2414    

DOI:10.1159/000226887

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

A new tumour marker, CAR-3, was isolated using the monoclonal antibody technique and measured in the sera of 27 patients with pancreatic cancer, 25 chronic pancreatitis, 30 extra-pancreatic diseases and in that of 18 healthy controls in order (1) to evaluate the diagnostic role of CAR-3 in patients with pancreatic cancer and (2) to ascertain whether liver dysfunction influences CAR-3 serum levels. The increased levels were found in 12/27 patients with pancreatic cancer (sensitivity 44.4%). No increase was found in patients with chronic pancreatitis, whereas abnormal levels were found in patients with other gastrointestinal diseases, especially those of the liver and biliary tract. Correlations were found between serum CAR-3 and (1) total bilirubin and (2) alkaline phosphatase. In conclusion, CAR-3, an antigen structurally related to CA 19–9, does not appear to be accurate enough to be considered a tumour marker. Cholestasis seems to increase CAR-3 levels as well as those of other glycoproteic tumour markers, probably by interfering with the hepatic clearance of these substances.

ISSN:0030-2414    

DOI:10.1159/000226888

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

From June 1981 to June 1989 we diagnosed 174 cases of hepatocellular carcinoma (HCC) at our institution (Piacenza, Northern Italy). Average age was 65.6 years; male to female ratio 3.4. 149 patients were cirrhotic (85.6%); alcohol abuse was present in 88/169 (52.1%); in 53/145 patients all hepatitis B virus markers were negative. Alpha-fetoprotein showed a low diagnostic sensitivity (values above 500 ng only in 49/169 or 29.0%). We used ultrasound (US) examination with a very high identification rate in all cases; pathological diagnosis was achieved by US guided fine-needle aspiration biopsy in 135 patients; in 13, by laparoscopy-histol-ogy. Metastases were found in 24/169 cases (14.2%); a second malignancy was diagnosed in 13/169 (7.7%): the most common association was HCC-non-Hodgkin lymphoma. Only 14 patients could be referred to surgery, which significantly improved prognosis.

ISSN:0030-2414    

DOI:10.1159/000226889

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

We have observed that a fairly large amount of vanillylmandelic acid and homovanillic acid in urine samples taken randomly from patients with a tumor of about 10 g was less than the cutoff values and overlapped with the respective ranges of normal infants. Consequently, with only a single random urine sample there is a risk of overlooking a patient, especially in cases where the tumor is small. However, according to theoretical calculation, several random urine samples may enable us to discriminate a patient from a normal infant and can replace the 24-hour urine accumulation for 3 days which is currently performed for final judgement in the mass screening of neuroblastoma. urine sample randomly taken can replace the 24-hour urine specimen. In the present report, we investigate whether a patient can be discriminated from a normal infant by randomly sampled urine.

ISSN:0030-2414    

DOI:10.1159/000226890

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Chemosensitivity of hepatocellular carcinoma tissues from 72 patients to 6 antitumor agents was assayed using the succinate dehydrogenase inhibition test. Sensitivity was positive in 47.2% of tissues exposed to adriamycin, 53.5% to mitomycin C, 10.3% to 5-fluorouracil, 51.5% to cisplatin and aclacinomycin A, respectively, and 52.9% to carboquone. Eight percent of the tissues were sensitive to all 6 drugs, while the resistance rate to all drugs was 36.5%. The remaining 55.5% were sensitive to only some of the drugs. When a comparison of the sensitivity to the 6 drugs was made between two different areas of tumors in 16 patients, positive or negative sensitivity was in a range of 76.9–92.9%. The hypovascular masses seen on the angiography and the histologically well differentiated tumors were resistant to adriamycin, a drug most commonly prescribed to treat patients with liver cancer. For some of these tumors, mitomycin C or carboquone may be effective. Our observation shows that the succinate dehydrogenase inhibition test is useful for determining which drugs will be effective for a particular tumo

ISSN:0030-2414    

DOI:10.1159/000226891

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

DNA flow cytometry was carried out on 804 primary melanomas. The data were analyzed with a follow-up of 24–96 months. 57% of the cases were diploid, 32% had one abnormal cell population, and 11% were multiclonal. In 8% of the aneuploid tumors there were cell lines in the hypertetraploid range. A reliable S phase determination was possible in 524 cases. Among these 11 % had an S phase exceeding 15%. Using an increased tumor thickness, relapse rate and mortality as criteria of tumor progression, aneuploidy and multiclonality, the occurrence of hypertetraploid cell lines and a high S phase ( > 15%) proved to be correlated with a poor prognosis.

ISSN:0030-2414    

DOI:10.1159/000226892

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Data collected by the Cancer Registry of the Canton of Vaud, Switzerland, were used to estimate the risk of suicide for patients diagnosed with cancer. Among 24,166 cases of invasive neoplasms other than nonmelanomatous skin cancer reported between 1976 and 1987 and followed through integrated active follow-up to the end of 1987, for a total of 57,164 person years at risk, there were 55 registered suicides vs. 21.3 expected (standardized mortality ratio, SMR = 2.6; 95% confidence interval, CI = 2.0–3.4). The ratio was slightly, but not significantly higher for males (SMR = 2.8) than for females (SMR = 2.2) and comparable across subsequent age groups. The risk of suicide was high during the 1st year after notification (SMR = 3.9) and decreased to 2.2 between 1 and 5 years and to 1.5 over 5 years. This study suggests that the risk of suicide after a diagnosis of cancer may be greater than previously estimated from cancer registry data in Finland, Sweden, and Connecticut (USA), at least in this population of Central Europe with high overall suicide rates.

ISSN:0030-2414    

DOI:10.1159/000226893

出版商:S. Karger AG    

年代:1991

数据来源: Karger