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1.
Rev. Soc. Bras. Clín. Méd ; 17(1): 7-10, jan.-mar. 2019. tab.
Artigo em Português | LILACS | ID: biblio-1025951

RESUMO

Objetivo: Descrever o padrão histopatológico e identificar a incidência de carcinomatose peritoneal no momento do diagnóstico de mulheres diagnosticadas com neoplasia de ovário. Métodos: Trata-se de um estudo transversal e descritivo, baseado na análise secundária de dados correspondentes aos prontuários de mulheres adultas com diagnóstico de neoplasia de ovário de um serviço de referência em oncologia clínica. Foram analisados 40 prontuários entre janeiro de 2007 e janeiro de 2017. Resultados: Ao estadiamento segundo o sistema da International Federation of Gynecology and Obstetrics, três mulheres (7,5%) apresentavam estadiamento clínico (EC) II, três (77,5%) estágio ECIII com carcinomatose peritoneal/invasão da pelve e seis (15%) estágio ECIV com metástases à distância, especialmente para pulmão e fígado. Em relação ao padrão histopatológico, 20 mulheres apresentaram adenocarcinoma seroso papilífero de alto grau (50%), 4 (10%) adenocarcinoma seroso papilífero de baixo grau, 3 (7,5%) adenocarcinoma endometrioide, 3 (7,5%) tumor de teca/granulosa, 3 (7,5%) carcinoma de células claras, 3 (7,5%) tumores não classificados, 2 (5%) disgerminoma e 2 (5%) com cistoadenocarcinoma mucinosos. Conclusão: É nítida a necessidade de mais estudos envolvendo essa patologia, de modo a favorecer o diagnóstico e a intervenção em estágios mais precoces e reduzir desfechos desfavoráveis. (AU)


Objective: To describe the histopathological pattern, and to identify the incidence of peritoneal carcinomatosis at the time of the diagnosis of women diagnosed with ovarian neoplasm. Methods: This is a cross-sectional and descriptive study, based on the secondary analysis of data corresponding to the medical records of adult women diagnosed with ovarian neoplasm in a reference service of clinical oncology. A total of 40 medical records were analyzed between January 2007 and January 2017. Results: At the staging (FIGO system) of the International Federation of Gynecology and Obstetrics, three women (7.5%) had clinical staging (EC) II staging, 31 (77.5%) were in the ECIII stage, with peritoneal carcinomatosis/pelvic invasion, six (15%) were in the ECIV stage, with metastases at a distance, especially to lung and liver. Regarding the histopathological pattern, twenty women had high-grade papillary serous adenocarcinoma (50%), 4 (10%) with low-grade papillary serous adenocarcinoma, 3 (7.5%) with endometrioid adenocarcinoma, 3 (7.5%) with granulosa-theca tumor, 3 (7.5%) with clear cell carcinoma, 3 (7.5%) with unclassified tumors, 2 (5%) with dysgerminoma, two (5%) with mucinous cystadenocarcinoma. Conclusions: There is a clear need for further studies involving this pathology, in order to favor diagnosis and intervention at earlier stages and to reduce unfavorable outcomes. (AU)


Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias Ovarianas/diagnóstico , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/epidemiologia , Neoplasias Ovarianas/complicações , Palpação , Neoplasias Peritoneais/complicações , Ascite/etiologia , Tumor da Célula Tecal/epidemiologia , Hemorragia Uterina/etiologia , Redução de Peso , Adenocarcinoma/epidemiologia , Dor Abdominal/etiologia , Registros Médicos/estatística & dados numéricos , Incidência , Estudos Transversais , Cistadenocarcinoma Mucinoso/epidemiologia , Carcinoma Endometrioide/epidemiologia , Adenocarcinoma de Células Claras/epidemiologia , Disgerminoma/epidemiologia , Metástase Neoplásica , Estadiamento de Neoplasias/classificação
2.
Eur J Cancer ; 91: 30-37, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29331749

RESUMO

METHODS: French patients (≤18years) treated for dysgerminoma between 1985 and 2005 in TGM-85, 90, 95 protocols were included. Treatment was based on primary unilateral oophorectomy followed by prophylactic lymph node irradiation (1985-1998) or a wait-and-see strategy (1998-2005) for localised completely resected tumours (pS1) or by platinum-based chemotherapy for advanced diseases. RESULTS: Forty-eight patients (median age 12.8 years) were included. Six patients had gonadal dysgenesis. Two had bilateral dysgerminoma. Twenty-eight patients had loco-regional dissemination, seven with para-aortic lymph nodes. None had distant metastases. Primary surgery was performed in 47/48 patients. Among the 15 patients with pS1 tumour: seven did not receive adjuvant treatment, six had lymph node irradiation and two received chemotherapy. Among the 32 patients with advanced tumour, 31 received cisplatinum-based (n = 25) or carboplatin-based (n = 8) regimen with lymph node irradiation for one of them and one did not receive adjuvant treatment. With a median follow-up of 14 years, all patients are alive in complete remission. Five events occurred: 2 contralateral dysgerminomas, 1 peritoneal relapse and 2 second neoplasms (teratoma and melanoma). Bilateral oophorectomy was necessary for 12 patients. Desire of pregnancy was expressed for 17/36 patients with unilateral oophorectomy, which succeeded in 13 cases (5 medically assisted). 2/17 had ovarian failure. The renal function was normal in 24/25 evaluated patients treated with platinum, ifosfamide or irradiation. The hearing function was evaluated on 17/36 patients treated with platinum: 12 Brock grade-0, 3 brock grade-1 and 2 grade-4. CONCLUSION: Dysgerminoma has an excellent prognosis even in advanced cases with conservative surgery and platinum-based chemotherapy. However the disease and/or treatment resulted in a high rate of bilateral oophorectomies and a significant impact on future fertility.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Sobreviventes de Câncer , Carboplatina/administração & dosagem , Cisplatino/administração & dosagem , Disgerminoma/terapia , Neoplasias Ovarianas/terapia , Ovariectomia , Adolescente , Idade de Início , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Carboplatina/efeitos adversos , Quimioterapia Adjuvante , Criança , Cisplatino/efeitos adversos , Intervalo Livre de Doença , Disgerminoma/epidemiologia , Disgerminoma/secundário , Feminino , França/epidemiologia , Humanos , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/terapia , Metástase Linfática , Recidiva Local de Neoplasia , Segunda Neoplasia Primária , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/patologia , Ovariectomia/efeitos adversos , Radioterapia Adjuvante , Técnicas de Reprodução Assistida , Fatores de Tempo , Resultado do Tratamento
3.
J Obstet Gynaecol ; 36(4): 515-7, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26789784

RESUMO

A retrospective study was conducted to review incidence, clinical practice, surgical management and histology of adolescent ovarian masses in order to audit and improve future practices. Complete hospital records of all adolescents between 10 and 20 years who had undergone surgery for ovarian masses were analysed between November 2006 to 2014. Parameters analysed were age, clinical features, diagnosis, operative procedure and histopathology. Ninety-four patients were included in the study and among them, 37 had non-neoplastic masses, 30 had benign neoplasms while 27 had malignant tumors. The main clinical presentations were abdominal pain (54%) and abdominal mass (41%). Dermoid was the most common benign neoplasm while germ cell tumor was the most common malignant mass; dysgerminoma being the commonest (68%). Malignancy was more common in early adolescence (12 ± 4.8 years) while non-neoplastic masses were seen more frequently in late adolescence (17.7 ± 2.2 years). There was a fair correlation between ultrasound and histopathological diagnosis.


Assuntos
Procedimentos Cirúrgicos em Ginecologia/estatística & dados numéricos , Cistos Ovarianos/epidemiologia , Neoplasias Ovarianas/epidemiologia , Adolescente , Criança , Cisto Dermoide/epidemiologia , Cisto Dermoide/cirurgia , Disgerminoma/epidemiologia , Disgerminoma/cirurgia , Feminino , Hospitais/estatística & dados numéricos , Humanos , Cistos Ovarianos/cirurgia , Neoplasias Ovarianas/cirurgia , Estudos Retrospectivos , Adulto Jovem
4.
Ginekol Pol ; 82(5): 338-43, 2011 May.
Artigo em Polonês | MEDLINE | ID: mdl-21851031

RESUMO

OBJECTIVES: Presentation of a group of patients with diagnosed malignant ovarian germ cell tumors (MOGCT), determination of prognostic factors and outcome analysis. MATERIAL AND METHODS: We selected patients with diagnosed malignant ovarian germ cell tumors from the patient registry of Cancer Center in Warsaw from 1990 to 2001. We analyzed clinical and pathological features of the study group, as well as methods and results of treatment. RESULTS: We collected documentation of 83 patients. Most were diagnosed with dysgerminoma and immature teratoma in the early stages of development. 73 patients received adjuvant chemotherapy after surgery At the end of the first line of treatment complete response was achieved in 63 patients (75.9%). Time to recurrence ranged from 25 to 518 days (mean 176 days). The most common site of recurrence was the true pelvis. The five-year overall survival was 62.7%. Significant favorable prognostic factor was early stage of disease and the histological diagnosis of dysgerminoma. From the 46 women after fertility-sparing surgery, 8 became pregnant. CONCLUSIONS: MOGCT are a group of potentially curable, yet very aggressive malignant ovarian tumors. The main condition for obtaining good results is quick diagnosis and appropriate treatment, usually surgery associated with multidrug chemotherapy The stage of the disease remains the most important prognostic factor. Patients diagnosed with dysgerminoma are a separate group with very good prognosis.


Assuntos
Neoplasias Embrionárias de Células Germinativas/epidemiologia , Neoplasias Embrionárias de Células Germinativas/terapia , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/terapia , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Terapia Combinada , Disgerminoma/diagnóstico , Disgerminoma/epidemiologia , Disgerminoma/patologia , Disgerminoma/secundário , Disgerminoma/terapia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Embrionárias de Células Germinativas/secundário , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/patologia , Ovariectomia/métodos , Polônia/epidemiologia , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento , Adulto Jovem
5.
J Pediatr Surg ; 46(1): e13-9, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21238625

RESUMO

Hypercalcaemia is a rare life-threatening complication of paediatric cancer that is commoner in haematological than solid malignancies and associated rarely with acute renal failure. Often refractory to medical therapy, control of hypercalcaemia in children with solid tumours may necessitate excision of localised tumours or urgent chemotherapy for metastatic ones. We present a child with refractory hypercalcaemia, bulky chemosensitive metastatic tumours and acute renal failure in whom chemotherapy posed high-risk of tumour lysis syndrome (TLS). Resection of the metastatic tumours successfully normalised the hypercalcaemia and represents a practical alternative control strategy in cases at high risk of TLS.


Assuntos
Disgerminoma/cirurgia , Hipercalcemia/prevenção & controle , Síndrome de Lise Tumoral/prevenção & controle , Injúria Renal Aguda/epidemiologia , Criança , Disgerminoma/epidemiologia , Disgerminoma/secundário , Feminino , Humanos , Fatores de Risco , Síndrome de Lise Tumoral/etiologia
6.
J Natl Cancer Inst ; 97(14): 1056-66, 2005 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-16030303

RESUMO

BACKGROUND: Although risk estimates for synchronous and metachronous contralateral testicular cancers vary widely, many clinicians recommend routine biopsy of the contralateral testis for patients diagnosed with unilateral testicular cancer. We evaluated the risk of contralateral testicular cancer and survival in a large population-based cohort of men diagnosed with testicular cancer before age 55 years. METHODS: For 29 515 testicular cancer cases reported to the National Cancer Institute's Surveillance, Epidemiology and End Results Program from 1973 through 2001, we estimated the prevalence of synchronous contralateral testicular cancer, the observed-to-expected ratio (O/E) and 15-year cumulative risk of metachronous contralateral testicular cancer, and the 10-year overall survival rate of both synchronous and metachronous contralateral testicular cancer, using the Kaplan-Meier method for the two latter assessments. Age-adjusted multivariable analyses were used to examine risk according to histologic type of the original cancer. RESULTS: A total of 175 men presented with synchronous contralateral testicular cancer; 287 men developed metachronous contralateral testicular cancer (O/E = 12.4 [95% confidence interval {CI} = 11.0 to 13.9]; 15-year cumulative risk = 1.9% [95% CI = 1.7% to 2.1%]). In the multivariable analysis, only nonseminomatous histology of the first testicular cancer was associated with a statistically significantly decreased risk of metachronous contralateral testicular cancer (hazard ratio [HR] = 0.60, 95% confidence interval [CI] = 0.46 to 0.79; P<.001). Increasing age at first testicular cancer diagnosis was associated with decreasing risk of nonseminomatous metachronous contralateral testicular cancer (odds ratio = 0.90, 95% CI = 0.86 to 0.94). The 10-year overall survival rate after metachronous contralateral testicular cancer diagnosis was 93% (95% CI = 88% to 96%), and that after synchronous contralateral testicular cancer was 85% (95% CI = 78% to 90%). CONCLUSIONS: The low cumulative risk of metachronous contralateral testicular cancer and favorable overall survival of patients diagnosed with metachronous contralateral testicular cancer is in accordance with the current U.S. approach of not performing a biopsy on the contralateral testis.


Assuntos
Neoplasias Primárias Múltiplas/epidemiologia , Segunda Neoplasia Primária/epidemiologia , Neoplasias Testiculares/epidemiologia , Adulto , Intervalos de Confiança , Disgerminoma/epidemiologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Neoplasias Primárias Múltiplas/mortalidade , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/terapia , Segunda Neoplasia Primária/mortalidade , Segunda Neoplasia Primária/patologia , Segunda Neoplasia Primária/terapia , Razão de Chances , Prevalência , Modelos de Riscos Proporcionais , Medição de Risco , Programa de SEER , Seminoma/epidemiologia , Análise de Sobrevida , Neoplasias Testiculares/mortalidade , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia , Estados Unidos/epidemiologia
7.
Eur J Gynaecol Oncol ; 24(6): 569-73, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14658607

RESUMO

OBJECTIVE: In this study, some clinicopathologic characteristics and the outcome of patients with malignant ovarian germ cell tumors (MOGCT) were evaluated. MATERIALS AND METHODS: The clinical charts and pathologic reports of 32 patients with MOGCT treated at the Department of Obstetrics and Gynecology, and diagnosed at the Department of Pathology, Medical Faculty of Dicle University, Turkey from 1983 to 1999 were reviewed. RESULTS: Thirteen patients (40.6%) had dysgerminoma, nine (28.1%) had immature teratoma (four grade 1, three grade 2, and two grade 3), eight (25%) had endodermal sinus tumor, and two (6.3%) patients had mixed germ cell tumors. Site of involvement was unilateral in 30 (19 on the right and 11 on the left) and bilateral in two. All patients underwent primary surgery and 26 patients combination chemotherapy. There seemed to be a relationship between pathologic findings and clinical outcome, and MOGCT histologic types may affect the prognosis. CONCLUSION: Dysgerminoma had a better prognosis than the nondysgerminomatous group (p < 0.05). This study provides additional data in confirmation of previous reports that management of MOGCT with fertility preservation is safe.


Assuntos
Germinoma/epidemiologia , Germinoma/terapia , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/terapia , Adolescente , Adulto , Disgerminoma/epidemiologia , Disgerminoma/etiologia , Disgerminoma/patologia , Disgerminoma/terapia , Tumor do Seio Endodérmico/epidemiologia , Tumor do Seio Endodérmico/etiologia , Tumor do Seio Endodérmico/patologia , Tumor do Seio Endodérmico/terapia , Feminino , Fertilidade , Germinoma/etiologia , Germinoma/patologia , Humanos , Registros Médicos , Neoplasias Ovarianas/etiologia , Neoplasias Ovarianas/patologia , Estudos Retrospectivos , Teratoma/epidemiologia , Teratoma/etiologia , Teratoma/patologia , Teratoma/terapia , Resultado do Tratamento , Turquia/epidemiologia
8.
J Natl Cancer Inst ; 95(16): 1238-40, 2003 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-12928349

RESUMO

Although the incidence of testicular cancer is increasing, substantial differences in incidence between countries and populations exist. These differences cannot be explained solely by genetic differences, but environmental exposures, particularly early exposures, have been implicated in the etiology of testicular cancer. To assess whether early exposures contribute to the incidence of testicular cancer, we identified 93 172 Finnish men who immigrated to Sweden between 1969 and 1996 and followed them for the occurrence of testicular cancer. The risk of testicular cancer was lower for Finnish immigrants to Sweden than for the Swedish general population (standardized incidence ratio [SIR] = 0.34, 95% confidence interval [CI] = 0.21 to 0.53). The reduced risk was associated with both seminomas and non-seminomas. Neither age at immigration nor duration of stay in Sweden had any impact on the reduced risk. Although the type of environmental exposures remains unknown, the results strongly indicate that early exposures are major determinants for testicular cancer.


Assuntos
Emigração e Imigração , Neoplasias Testiculares/epidemiologia , Adulto , Fatores Etários , Idoso , Estudos de Coortes , Disgerminoma/epidemiologia , Finlândia/etnologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Seminoma/epidemiologia , Suécia/epidemiologia , Neoplasias Testiculares/etnologia , Neoplasias Testiculares/etiologia , Fatores de Tempo
9.
Cancer Radiother ; 3(4): 297-304, 1999.
Artigo em Francês | MEDLINE | ID: mdl-10486540

RESUMO

PURPOSE: Retrospective analysis of 17 patients with intracranial germ cell tumors treated in a multidisciplinary consultation at the Bordeaux University Hospital a and literature review. MATERIALS AND METHODS: Seventeen consecutive patients were treated from 1978 to 1995 for a primary intracranial germ cell tumor. Median age was 14 (range 3-29 years). There were two malignant teratoma, six proved germinoma and nine presumed germinoma (diagnostic based on biological, radiological and treatment criteria). All received radiotherapy from 30 to 60 Gy (median 40 Gy) in different volumes. Chemotherapy was administered in 15 cases, three after surgery and 12 after radiotherapy. RESULTS: All tumours were in complete remission after initial treatment. The two malignant teratomas recurred in non-irradiated area after nine and 48 months, and the patients died. None of the germinoma recurred within a follow-up period of two to 17 years (median 65 months). Five and 10 year actuarial overall survival rates were the same: 84% for all histologies and 100% for germinomas. Only two patients developed school difficulties and six presented an hypopituitarism, of which one was consecutive to radiotherapy. Chemotherapy was well tolerated. CONCLUSION: This retrospective study and literature analysis are in favor of limited dose and volume of radiation therapy associated with chemotherapy.


Assuntos
Neoplasias do Sistema Nervoso Central/radioterapia , Disgerminoma/radioterapia , Adolescente , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/análise , Neoplasias do Sistema Nervoso Central/tratamento farmacológico , Neoplasias do Sistema Nervoso Central/epidemiologia , Neoplasias do Sistema Nervoso Central/cirurgia , Quimioterapia Adjuvante , Criança , Pré-Escolar , Gonadotropina Coriônica Humana Subunidade beta/análise , Terapia Combinada , Disgerminoma/tratamento farmacológico , Disgerminoma/epidemiologia , Disgerminoma/cirurgia , Feminino , França/epidemiologia , Hospitais Universitários/estatística & dados numéricos , Humanos , Tábuas de Vida , Masculino , Radioterapia Adjuvante , Indução de Remissão , Estudos Retrospectivos , Análise de Sobrevida , alfa-Fetoproteínas/análise
10.
Rev. colomb. obstet. ginecol ; 45(1): 75-8, ene.-mar. 1994. ilus
Artigo em Espanhol | LILACS | ID: lil-293278

RESUMO

Siendo el Disgerminoma el tumor de células germinales más común en mujeres jóvenes, es también de los menos frecuentes de los tumores de ovario, oscilando su incidencia en Colombia del 0.48 a 0.55 por ciento. Se presentan dos casos atendidos en el Departamento de Ginecología y Obstetricia del Hospital Universitario Metropolitano en un período de 10 años


Assuntos
Humanos , Feminino , Adulto , Disgerminoma/complicações , Disgerminoma/diagnóstico , Disgerminoma/epidemiologia , Disgerminoma/etiologia , Disgerminoma/patologia , Disgerminoma/fisiopatologia , Disgerminoma/cirurgia
11.
Int J Radiat Oncol Biol Phys ; 26(3): 381-90, 1993 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-7685748

RESUMO

PURPOSE: In 1984 the following changes were made in the management of testicular seminoma at The University of Texas M.D. Anderson Cancer Center: (1) abdominopelvic computerized tomography replaced the bipedal lymph-angiogram for evaluating retroperitoneal nodes; (2) elective mediastinal radiation was totally abandoned; (3) patients with abdominal adenopathy < 10 cm were classified as having Stage IIA disease. This report evaluates the impact of these management policy changes on disease outcome. METHODS AND MATERIALS: Between 1960 and 1991, 350 patients with Stages I or II testicular seminoma received post-orchiectomy radiation. The 241 patients treated prior to 1984 constitute our old series, and the 109 patients treated since then are our new series. The outcomes in the new series were compared to those in the old series. RESULTS: The distribution of patients by stage was Stage I, 282 (old series, 190; new series, 92); Stage IIA, 55 (old series, 39; new series, 16); Stage IIB, 13 (old series, 12; new series, 1). The freedom-from-relapse at 5 years correlated with stage: Stage I, 97%; Stage IIA, 87%; Stage IIB, 69%. Elevated post-orchiectomy chorionic gonadotropin levels or involvement of the spermatic cord were adverse for disease relapse in Stage I but not Stage II disease. Patients with Stage I disease fared extremely well in both series (freedom-from-relapse 97%); the outcome for patients with Stage IIA was significantly worse in the new series (5-year freedom-from-relapse 73% vs. 92%) because of a 20% actuarial incidence of apparently solitary left supraclavicular nodal relapse. Although elective mediastinal radiation in the old series prevented this failure pattern, such treatment appeared to significantly decrease the survival of patients older than 40 years. CONCLUSIONS: (1) Abdominopelvic computerized tomography scanning is adequate for the evaluation of abdominal lymph nodes in patients with seminoma; (2) Post-orchiectomy radiation to the para-aortic and ipsilateral hemipelvic regions remains the treatment of choice for patients with Stage I disease; (3) Patients with Stage IIA disease experience a 20% relapse rate especially in the left supraclavicular fossa and we recommend elective radiation to this site delivered concomitantly with para-aortic irradiation.


Assuntos
Disgerminoma/radioterapia , Orquiectomia , Neoplasias Testiculares/radioterapia , Adolescente , Adulto , Biomarcadores Tumorais/sangue , Gonadotropina Coriônica/sangue , Gonadotropina Coriônica Humana Subunidade beta , Terapia Combinada , Disgerminoma/epidemiologia , Disgerminoma/cirurgia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fragmentos de Peptídeos/sangue , Estudos Retrospectivos , Análise de Sobrevida , Neoplasias Testiculares/epidemiologia , Neoplasias Testiculares/cirurgia
12.
Int J Radiat Oncol Biol Phys ; 26(2): 305-10, 1993 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-8491688

RESUMO

PURPOSE: To evaluate functional post-radiotherapy arterial change in a select patient population. METHODS AND MATERIALS: Thirty-five seminoma patients were identified in the Radiation Oncology departmental records at Indiana University Medical Center. In this group the ipsilateral pelvis is treated with the contralateral pelvis available for evaluation as a matched control. Additionally, this group is generally young and unlikely to have pre-existing vascular disease, and shows excellent radiocurability with historically standard radiotherapy. Nineteen patients volunteered for a noninvasive vascular evaluation which included: Doppler ultrasound, segmental leg pressures, pulse volume recordings, and post-exercise testing. Average age at treatment was 36 (range 14-68) with an average follow-up of 8.8 years (range 1-20) with five patients now over 15 years post-treatment. The majority of the patients received 2500-2600 cGy. RESULTS: Three of 19 patients had abnormal vascular evaluations. Of these, two had bilateral abnormalities not felt to be solely associated with irradiation. The remaining patient showed both resting and post-exercise ipsilateral vascular abnormalities. Irradiation was the only identifiable etiologic agent for this patient's vascular abnormality. CONCLUSION: Subclinical vascular change attributable to low dose radiotherapy was identified in one of 19 patients (5%). Considering the radiocurability of seminoma patients this incidence is acceptable. In light of this slight, yet documented, arterial abnormality occurring with low dose radiotherapy, we recommend additional study of high dose radiotherapy patients to determine the incidence and morbidity of radiation-induced arteriopathy in this group.


Assuntos
Artérias/efeitos da radiação , Disgerminoma/radioterapia , Perna (Membro)/irrigação sanguínea , Radioterapia/efeitos adversos , Neoplasias Testiculares/radioterapia , Adolescente , Adulto , Idoso , Disgerminoma/epidemiologia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias Testiculares/epidemiologia
13.
Curr Opin Oncol ; 5(3): 559-67, 1993 May.
Artigo em Inglês | MEDLINE | ID: mdl-8388258

RESUMO

Despite the overall cure rate now in excess of 90%, innovation in management of germ cell tumors continues. The report that 80% of patients with extragonadal germ cell tumors have either carcinoma in situ or atrophic tubules as evidence of tumor rejection emphasizes the need to investigate the testis in patients with undiagnosed primary cancer because even today treatment delay is worsening prognosis. The evidence that testicular atrophy is a precursor of malignancy may explain why testis cancer has increased while normal sperm count has fallen over the past 50 years and why there is an association between exposure during service in Vietnam to agents that damage spermatogenesis and development of testis cancer. The improved prognostication from analysis of large databases and salvage with high-dose chemotherapy and bone marrow rescue are giving confidence to explore new innovations, eg, carboplatin instead of cisplatin. In addition, as the database on patients with stage I disease on surveillance enlarges, so does interest in adjuvant chemotherapy, encouraging the search for better markers to predict poor response. Linkage between overproduction of the tumor marker lactate dehydrogenase-1 and the increased copy number of the isochrome 12p in the tumor may be of use in this respect. Reports that germ cell tumor patients exposed to etoposide, eg, leukemic, lung, and ovarian cancer patients, can develop an acute myeloid leukemia with a marker on chromosome 11 are tempering enthusiasm for its use in adjuvant therapy. However, the observation that radiotherapy or chemotherapy may reduce second testis tumor incidence more effectively than surgery does encourages more detailed exploration of the results of adjuvant treatment.


Assuntos
Disgerminoma , Neoplasias Embrionárias de Células Germinativas , Neoplasias Testiculares , Disgerminoma/epidemiologia , Disgerminoma/patologia , Disgerminoma/terapia , Humanos , Masculino , Neoplasias Embrionárias de Células Germinativas/epidemiologia , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Embrionárias de Células Germinativas/terapia , Neoplasias Testiculares/epidemiologia , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia
14.
Strahlenther Onkol ; 169(4): 242-9, 1993 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-8488460

RESUMO

In the radiotherapist's point of view lymphography and computed tomography scan compete for staging and therapy planning of testicular seminoma. We investigated whether lymphogram can be replaced by computed tomography scan. 114 patients with histologically confirmed seminoma of the testis were treated by radiotherapy at the Nürnberg Community Hospital (n = 65) and the University of Erlangen (n = 49) from 1978 through 1991. Radiological staging included both computed tomography scan and lymphography in all cases. The results of both methods were similar in 79%. Computed tomography scan led to an upstaging in 4% while lymphography was negative. 17% of the patients showed negative results considering computed tomography scan while lymphogram was positive. In accordance with these data treatment portals or doses were altered in 21%. Using the M.D. Anderson Hospital clinical staging system a stage IIa (micrometastasis < 2 cm) is not safely identified by computed tomography scan. Just lymphography can safely identify a stage IIa patient. On the other hand, lymphography shows a very high amount of false positive interpretations. However, two conclusions are made: 1. Using a conventional technic (radiation of para-aortal and ipsilateral iliac region, dose about 30 Gy HD) lymphogram can be superseded by computed tomography scan. 2. In the case of reducing treatment volume and/or dose lymphogram should be added to computed tomography scan.


Assuntos
Disgerminoma/diagnóstico por imagem , Linfografia , Neoplasias Testiculares/diagnóstico por imagem , Disgerminoma/epidemiologia , Disgerminoma/patologia , Disgerminoma/radioterapia , Alemanha Ocidental/epidemiologia , Humanos , Irradiação Linfática , Metástase Linfática , Linfografia/estatística & dados numéricos , Masculino , Estadiamento de Neoplasias , Dosagem Radioterapêutica , Estudos Retrospectivos , Neoplasias Testiculares/epidemiologia , Neoplasias Testiculares/patologia , Neoplasias Testiculares/radioterapia , Tomografia Computadorizada por Raios X/estatística & dados numéricos
15.
Diagnóstico (Perú) ; 31(1/3): 14-8, ene.-mar. 1993. tab
Artigo em Espanhol | LILACS | ID: lil-132477

RESUMO

En el Hospital Belén de Trujillo desde enero de 1965 hasta setiembre de 1992 se atendieron 21 pacientes portadoras de tumores ováricos malignos de células germinales. Estos casos fueron estudiados para determinar su incidencia, cuadro clínico y su tratamiento. Estos tumores representaron el 2.18 por ciento de todas las neoplasias ováricas, y el 16.5 por ciento de todas las neoplasias malignas del ovario. Los exámenes anatomopatológicos revelaron multiples tipos tumorales, siendo el mas frecuente el disgerminoma(42.8 por ciento). El dolor y la tumoración obligó a las pacientes a acudir al nosocomio donde se advirtio un corto tiempo de evolución. La terapia consistió principalmente en la cirugía, completándose luego con radioterapia y quimioterapia, según era la naturaleza del tumor


Assuntos
Feminino , Pessoa de Meia-Idade , Humanos , Adolescente , Adulto , Células Germinativas/patologia , Disgerminoma/epidemiologia , Neoplasias Ovarianas/epidemiologia , Disgerminoma/patologia , Disgerminoma/terapia , Incidência , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/terapia , Dor
16.
APMIS Suppl ; 33: 122-36, 1993.
Artigo em Inglês | MEDLINE | ID: mdl-8512735

RESUMO

This chapter describes the survival of men with the two commonest cancers of the genital organs--cancer of the prostate and cancer of the testis. Prostatic cancer is largely a disease of old age and occurs at a rate of about 1400 new cases per year in Denmark. Testicular cancer is a rare disease, usually affecting men in their 20s and 30s. About 250 new cases occur annually in Denmark. Both prostatic and testicular cancer have been increasing in incidence over the period of cancer registration in Denmark. Relative survival of prostatic cancer patients improved over the period of study, with an increase in one-year survival from 52% around 1945 to 80% around 1985. The corresponding change in five-year survival was from 22 to 39%. The survival of testicular cancer patients increased in response to improvements in therapy: relative one-year survival increased from 70% around 1945 to 95% around 1985. The increase was particularly strong for non-seminomas, for which one-year survival increased from 53 to 94%. Excess mortality after a diagnosis of testicular cancer was most pronounced in the first few years after diagnosis; for prostatic cancer, mortality relative to that of the general population was about two fold, even 10 years after diagnosis.


Assuntos
Disgerminoma/mortalidade , Neoplasias da Próstata/mortalidade , Neoplasias Testiculares/mortalidade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Dinamarca/epidemiologia , Disgerminoma/epidemiologia , Disgerminoma/patologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/patologia , Sistema de Registros , Análise de Sobrevida , Taxa de Sobrevida , Neoplasias Testiculares/epidemiologia , Neoplasias Testiculares/patologia
17.
Eur Urol ; 23(1): 8-13; discussion 14-5, 1993.
Artigo em Inglês | MEDLINE | ID: mdl-8386660

RESUMO

The descriptive epidemiology of testicular cancer in Denmark shows that the incidence of both seminoma and non-seminoma has increased gradually since the 1940s to the present. The age-incidence pattern has remained unchanged, and is the same in the Nordic countries despite variation in the overall incidence level. Men born during the early 1940s have a lower risk in all age groups than expected from the overall trend in incidence. These observations support the idea that the occurrence of testicular cancer (both seminoma and non-seminoma) is determined early in life, and most probably before birth. Once the carcinogenic process is established, the age of occurrence of cancer or the histological type of the cancer does not seem to depend upon external factors.


Assuntos
Neoplasias Embrionárias de Células Germinativas/epidemiologia , Neoplasias Testiculares/epidemiologia , Adolescente , Adulto , Fatores Etários , Criança , Dinamarca/epidemiologia , Disgerminoma/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias Embrionárias de Células Germinativas/etiologia , Sistema de Registros , Fatores de Risco , Neoplasias Testiculares/etiologia
18.
Clin Oncol (R Coll Radiol) ; 5(1): 34-8, 1993.
Artigo em Inglês | MEDLINE | ID: mdl-7678749

RESUMO

The relapse patterns of 29 patients who recurred following treatment for metastatic germ cell tumours of the testis (seminoma n = 7, non-seminomatous germ cell tumour n = 22) have been analysed and the relative effectiveness of clinical follow-up and routine investigations in detecting relapse at an early stage have been examined. The analysis shows that routine estimation of the serum tumour markers human chorionic gonadotrophin and alpha-foetoprotein (HCG and AFP) is the single most important follow-up procedure. This is so, even in patients who were previously marker negative; it was the first indicator of relapse in 55% of the patients. Regular clinical examination and chest radiograph in asymptomatic patients was of little value. Chest radiograph gave the first evidence of relapse in only 2 cases (7%). The optimum frequency for follow-up computed tomographic scanning of the chest and abdomen remains debatable. In this series, it was the first abnormal investigation in 7 patients (24%) and proved to be particularly important in patients who had residual radiological abnormalities at the end of initial therapy. Cost analysis shows that intensive follow-up produces a total expenditure on investigations of approximately 4,500 pounds per relapse detected. Regular computed tomographic scanning is especially demanding on resources and costs approximately 12,880 pounds per relapse detected if the recommended protocol is followed.


Assuntos
Disgerminoma/epidemiologia , Recidiva Local de Neoplasia/epidemiologia , Neoplasias Embrionárias de Células Germinativas/epidemiologia , Neoplasias Testiculares/epidemiologia , Adulto , Gonadotropina Coriônica/sangue , Custos e Análise de Custo , Disgerminoma/diagnóstico , Disgerminoma/terapia , Seguimentos , Humanos , Masculino , Auditoria Médica , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Embrionárias de Células Germinativas/terapia , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/terapia , Fatores de Tempo , alfa-Fetoproteínas/análise
19.
Urology ; 40(6): 512-6, 1992 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-1334606

RESUMO

Benign testicular masses are recognized with increasing frequency and testis-sparing surgery, based on benign frozen section diagnosis, is practiced more often. However, there is a paucity of information in the medical literature regarding the accuracy of frozen section diagnoses of testicular tumors, and misdiagnoses could have dire consequences. We reviewed thirty frozen section examinations that were performed between 1962 and 1991, a period in which five hundred inguinal orchiectomies were performed. The entire testicle was available for histologic evaluation in 26 cases. Frozen sections correctly identified all of twenty-four malignant and two benign testicular masses. This study demonstrates that frozen section examinations can accurately diagnose testicular cancer.


Assuntos
Neoplasias Testiculares/patologia , Testículo/patologia , Adulto , Disgerminoma/epidemiologia , Disgerminoma/patologia , Secções Congeladas , Humanos , Masculino , Neoplasias Embrionárias de Células Germinativas/epidemiologia , Neoplasias Embrionárias de Células Germinativas/patologia , Valor Preditivo dos Testes , Estudos Retrospectivos , Neoplasias Testiculares/epidemiologia
20.
Rev. serv. sanid. fuerzas polic ; 53(2): 120-6, jul.-dic. 1992. tab
Artigo em Espanhol | LILACS | ID: lil-129300

RESUMO

Se describen 28 casos de cáncer testicular, acompañados de sus respectivos exámenes anátomo-patológicos, diagnosticados en el Hospital Central de Sanidad de la Policía Nacional del Perú, años 1987 a 1991. De acuerdo a la casuística encontrada, este tipo de patología ocupa el tercer lugar de las neoplasias urogenitales del varón, correspondiéndole el porcentaje del 16 por ciento del total. La evaluación de los casos, se realiza revisando sus respectivas historias clínicas, donde se logra obtener los datos requeridos para su tabulación. Se analizan los resultados, luego del tratamiento llevando a cabo, sus complicaciones, como también su pronóstico, realizando la respectiva comparación con lo que reporta la literatura. Dentro de los tipos histológicos del cáncer testicular, se menciona la mayor incidencia de presentación de seminoma y su mayor frecuencia de presentación, sobre todo en edades comprendidas entre la segunda y tercera década de la vida.


Assuntos
Criança , Pessoa de Meia-Idade , Humanos , Masculino , Adolescente , Adulto , Neoplasias Testiculares/patologia , Peru/epidemiologia , Neoplasias Testiculares/epidemiologia , Disgerminoma/patologia , Disgerminoma/epidemiologia , Prognóstico
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