[Efficacy of an adjuvant norethisterone acetate therapy (NEA) of endometrial carcinoma treated with primary surgery or irradiation]. / Die Effektivität einer adjuvanten norethisteronacetattherapie (NEA) nach primär operierten oder bestrahlten Endometriumkarzinomen.

UNLABELLED: The efficiency of NEA (norethisteronacetate) as an adjuvant hormone therapy in 196 pat. suffering from endometrial cancer has been evaluated in a prospective randomized trial. Primarily 93 patients had been operated on and 103 ones irradiated. From these 45 patients following surgery and 51 ones following radiation therapy had been treated with NEA. Schedule of adjuvant NEA therapy was for a time 6 ms 50 mg/d followed by 6 ms pause and so on till 5 years post op. 5 years survival in the operation group was 91.7 per cent without and 81.6 per cent with NEA, in the irradiated group 43.1 per cent and 44.8 per cent respectively. Side effect (47.9%) were caused by NEA at least twice higher than in control groups. IN CONCLUSION: the adjuvant hormone treatment without hormone receptor analysis is not recommendable.

[Effectiveness of cisplatin alone and in combination within the scope of primary therapy of ovarian cancer. Results of a prospective multicenter study]. / Die Effektivität von Cisplatin allein und in Kombination im Rahmen der Primärtherapie des Ovarialkarzinoms. Ergebnisse einer prospektiven Multizenterstudie.

The efficiency of cis Platin (DDP) alone and in combination with Adriamycine (ADM) and Cyclophosphamid (CTX) were evaluated in a prospective randomized trial containing 173 pat. suffering from advanced ovarian cancer (FIGO III/IV). Therapeutic schedule and results: (table; see text) The most side effects concerned vomiting (WHO Grad 2) in 90%, nausea (WHO Grad 2) in 95% and alopecia in 50% out of all pat.

[Tumor chemotherapy of ovarian cancer patients in advanced age]. / Die Tumorchemotherapie bei Ovarialkarzinompatientinnen im fortgeschrittenen Lebensalter.

Retrospectively the side effects caused by toxicity of cis-platinum chemotherapy combinations, the prolongation of the intervals in tumour chemotherapy without treatment determined by this, and the interruption of therapy caused by this 23 patients with ovarian cancer at an age of below 55 (average age 49.6 years) were contrasted with those of 25 patients with ovarian cancer, aged above 55. By means of the convergence table no significant differences in toxicity between the two age groups could be discerned at an error probability of 10 per cent. According to our experience the advanced age does not present any essential contra-indication for tumour chemotherapy in patients with ovarian cancer.

[Usefulness of cytologic studies on abdominal fluid in the control of patients with ovarian cancer]. / Zur Frage der Zweckmässigkeit zytologischer Untersuchungen von Abdominalflüssigkeit bei der Kontrolle von Patientinnen mit Ovarialkarzinomen.

A report is given about the efficacy of cytology which is gathered by trans-vaginal punction and lavage of the abdominal cavity in 95 patients with ovarian cancer treated before. The cytological findings were the following: Cytological examinations were negative (no tumour cells) in 61/95 cases (64.2%). Examinations were ambiguous in 16/95 cases (16.8%) and tumour cells could be proved in 18/95 cases (18.9%). Relapses appeared in the average time of 25 months after finishing of therapy in 17 cases (30%) with negative cytological examinations. We observed 3 relapses among the patients with ambiguous and 3 ones with positive tumour cells. The cytology of abdominal fluid seems to be a capable method in spite of its incompleteness for following up the patients suffering from ovarian cancer. The failure rate is calculated around 30%. Sonography and computerized tomography can complete the diagnostic spectrum.

[Prognostic significance of lymph node metastases in operable cervix cancer of categories T1 and T2]. / Uber die prognostische Bedeutung von Lymphknotenmetastasen beim operablen Zervixkarzinom der Kategorie T1 und T2.

In a retrospective long term study the tumorbiological importance of metastases in lymph-nodes of cervix cancer have been examined. The base of this presentation consists of a follow up study of 855 patients suffering from cervix cancer (stage I 557 pat., stage II 298 pat.) in relation to lymph-node-metastases. Metastases in 9,9% in stage I and in 18,4% in stage II could been proved histologically. The 5-year-survival-rate decreased in stage Ib from 89 (T1 No Mo) to 59% (T1 Ni Mo) and in stage II respectively (T2a No Mo) from 73 to 27% (T2a Ni Mo) and from 89 (T2b Ni Mo) to 52% (T2b Ni Mo). About 59% of relapses appeared in the treated region of the pelvis. In cases of adenomatous and dedifferentiated cancer 4% more regional metastases could be found than in squamous cell cancers. By means of post-operative irradiation (especially telecobalt-therapy) the relapse-free interval could be prolonged about one to two years. Recently tumourbiological knowledge is involved in the discussion. The appearance of lymph-node metastases represents the worst prognostic feature for the cure and the life of the patient suffering from cervical cancer.

[Experiences with cisplatin (Platidiam) chemotherapy in secondary resistant ovarian carcinomas]. / Erfahrungen mit der Cis Platin (Platidiam) Chemotherapie bei sekundär resistenten Ovarialkarzinomen.

Experiences with cis Platin therapy in cases of ovarian cancers after previous tumorchemotherapy are reported. 23 patients were treated with 100 mg cis Platin (DDP)/m2 (Lachema, CSSR, Brno) in intervals of four weeks following extensive hyperhydratation. We observed following therapeutic effects: CR 4 of 23 pat., PR 11 of 23 pat., NC 3 of 23 pat. and progression in 5 cases. The average remission-time was the best in cases with CR (8,3 month) and the worst in cases without any therapeutic effect (1 month). Side effects observed: severe vomiting was compulsory in all cases. Twice we observed neuro- and ototoxicity after the 5th respectively 6th cyclus. DDP is an effective but also toxic cytostatic drug for treatment of ovarian cancer in the 2nd or 3rd line. It should be used in cases of secondary resistant tumours.

[Problems in the therapy of ovarian carcinoma with gestagen-acting hormones]. / Zur Problematik der Therapie mit gestagenwirkenden Hormonen beim Ovarialkarzinom.

Our experience concerning the effectivity of progestogens (Noräthisteron 50 mg per os daily) in cases of advanced ovarian cancer is reported. Group 1 (25 pat.) suffering from less sensitive ovarian cancer was treated with cytotoxic drugs and hormones. The survival chance of combined hormonal and tumourchemotherapy was nearly 40% better than the survival chance with chemotherapy alone. In Group 2 (14 pat.) suffering from secondary resistant ovarian cancer chemotherapy was stopped, but the patients received hormones only. There were no better survival rate in this group. The biomolecular background is explained.

[Effectiveness of surgical and radiotherapeutic action on cervical carcinoma, stages I and II (T1 N0 M0 and T2 N0 M0). First communication]. / Zur Effektivität operativer und strahlentherapeutischer massnahmen beim Zervixkarzinom im Stadium I und II (T1 N0 M0 und T2 N0 M0).

Reported in this paper are therapeutic results obtained from 855 patients with cervical carcinoma, Category T1 (557 patients) and Category T2 (298 patients), between 1967 and 1976. -- Metastasization of lymph nodes was recorded from 9.9 per cent of the patients in Category T1 and from 18.4 per cent in T2. --Abdominal radical surgery (Wertheim's operation) was applied to 87.3 per cent, while vaginal radical surgery (modified according to Schauta) was performed on 8.2 per cent, and the socalled "minor Wertheim", a modification devised at the authors' hospital, to 4.5 per cent. Complementary postoperative irradiation was used on 497 of 855 patients, with 93.6 per cent of these patients receiving postoperative irradiation under orthovolt conditions and 6.4 per cent under telecobalt conditions. -- Five-year survival rates were 87.5 per cent without postoperative irradiation and 83 per cent with postoperative irradiation in Category T1 or 78.1 per cent without irradiation and 73.2 per cent with irradiation in Category T2. Survival rates declined by about 30 per cent in cases with lymph node metastases. Manifestation of local recurrence was found to be delayed by about one to one-a-half year by postoperative irradiation, an effect, however, which was no longer detectable after five years had passed. Differentiation of radiation doses had no bearings at all on healing. Adjuvant postoperative irradiation of patients in Category p T1 N0 M0 proved ineffective. Mortality following primary therapy amounted to 2.1 per cent. Morbidity accounted for 36.8 per cent of all patients, with due consideration being given to all intercurrent complications.

[Extended medical care for patients with ovarian carcinoma (author's transl)]. / Dispensairebetreuung von Ovarialkarzinompatienten.

Reported in this paper is a scheme of extended medical after-care for patients with ovarian carcinoma at the authors' outpatient department. An account is given of special consultations with routine care as well as individual postoperative treatment, using cytostatics and hormones. A strong demand is made for centralised treatment of patient with ovarian carcinoma which should cover the entire population within reach of the hospital concerned. Such centralisation also should be backup with sufficient personnel, equipment, and laboratory capacity.

[Cytogenetic studies for detection of tumour strain lines of ovarian cancer cells (author's transl)]. / Zytogenetische Untersuchungen zum Nachweis von Tumorzellstammlinien an Ovarialkarzinomzellen.

Reported in this paper are cytogenetic studies into cell cultures of tumour material, ascites, and pleural effusion obtained from 15 cases of histologically secured ovarian carcinoma. Identification of tumour cell strain lines was the purpose of those studies. Hypodiploid to hypertetraploid chromosome counts were established. Clearly pronounced peaks were recordable between 43 and 65 chromosomes, while smaller peaks were additionally established between 85 and 92 chromosomes. Numerical chromosome deviations were relating primarily to the C group. Marker chromosomes were established from six of 15 tumours. Different strain lines of tumour cells were recorded from twelve of 15 ovarian tumours. The number of cell strain lines was found to be in good agreement in 60 per cent of all findings, as compared with the oncobiograms.

The behaviour of tumour cells of ovarian carcinomata under in vitro conditions and the coincidence with clinical controllability of tumours.

The clinical significance of in vitro cytostatics testing, based on 96 patients with ovarian carcinomata over a 4-year period (1976-1979) is reported. Cell cultivation and short-time incubation are used for the purpose. The cytostatic effect are ascertained by microscopic comparative tests and determination of 3H-thymidine and -cytidine incorporation. The results obtained by in vitro methods coincide to about 70%. Ovarian carcinomata are most frequently sensitive to Adriblastin and least frequently to DTIC. The correlation rate between in vitro test results and clinical reality was 83%. The clinical significance of cytostatics testing in vitro consists in --the individualisation of the tumour chemotherapy, --the possibility of a prognostic estimate, --the ascertainment of causes of chemotherapy failure, --the prevention of useless therapeutic trials on the patient.

[The therapy of the early ovarian cancer (T1/T2 M0 N0) (author's transl)]. / Zur Therapie des Ovarialkariznos im lokal begrenzten Stadium T1/T2 M0 N0.

The paper deals with the results of a randomized prospective therapeutic study concerning 60 patients with ovarian cancers in stages T1 M0 N0 and T2 M0 N0 without (A group) and with (B group) postoperative chemotherapy, who had been operated on under a curative objective. The operative approach covered the abdominal exstirpation of the uterus with both adnexa and resection of the omentum. In stage T1 M0 N0 the 5-year survival time was reached by 94% of the patients without follow-up treatment (A group) and 90% of those who received such treatment (B group). In stage T2 M0 N0 all the patients without follow-up treatment (A group) and 76% of those cytostatically treated (B group) survived 5 years. While after a 10-year observation period the therapeutic results have remainded unchanged for stage T2 M0 N0 the survival rate of patients with tumours in stage T1 M0 N0 who hat received follow-up treatment has decreased to 62%. Statistical comparison of therapeutic concepts was not significant (error probability 5%). Attention is drawn to the importance of the operative approach. Ruptured secondura ovarian cancers and ascites do not anymore permit the curative approach and drastically reduce the chances of survival. Present methods of follow-up treatment cannot improve the effectiveness of the curatively performed operative measures take in case of ovarian cancer 5 of stages T1 M0 N0 and T2 M0 N0.

[Effectiveness of adjuvant chemotherapy in ovarian carcinoma]. / Zur Effektivität der adjuvanten Chemotherapie beim Ovarialkarzinom.

A report is given about the efficiency of the so called adjuvant chemotherapy in 26 cases (26 patients suffering from ovarian cancer in the stage T1M0N0) in a time of 10 years (1968-1977).--After the primary operation-therapy, a part of the patients (9) got the cytostatic drugs Trenimon or Cyclophosphamid. The patients of the control group got nothing. The survival times of both groups showed no significant distinctions. -- The results show that the adjuvant chemotherapy in cases of ovarian cancers in stage T1M0N0 can not be recommended because there are too many side effects of the these cytostatic drugs.