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  • 1
    ISSN: 1432-1084
    Keywords: Key words: Cervical carcinoma – MR imaging – Staging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. In this article the role of MR imaging in the management of cervical cancer is reviewed and illustrated. The appearance of the normal uterine cervix and of cervical carcinoma is shown. Important factors for optimal MR imaging of cervical carcinoma are reviewed. The value of MR imaging in the staging of cervical carcinoma is illustrated by showing parametrial invasion and lymph node involvement. Finally, the value of MR imaging staging is compared with clinical staging, CT staging, and surgical findings. The role of new imaging techniques, such as fast dynamic enhanced MR imaging, is described.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2307
    Keywords: Cervix uteri ; Shrinkage ; Histological technics ; Formaldehyde ; Paraffin ; Sectioning-mounting
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To evaluate the efficacy of cryocoagulation as a treatment for cervical intraepithelial neoplasia (C.I.N.), it is necessary to know the maximum depth of the glandular crypts, the maximum crypt involvement by C.I.N. and the extension of the cryolesion, obtained under standardized conditions. In a morphometric study on this subject, one has to take into account the shrinkage of the cervical tissue, caused by processing the tissue for histological examination. In the present study, tissue shrinkage of the cervix in different directions was measured in three separate steps. First shrinkage caused by formalin fixation was determined, second shrinkage caused by dehydration, clearing and paraffin wax embedding and finally that caused by section cutting and mounting. Shrinkage caused by formalin fixation, and by dehydration, clearing and paraffin wax embedding did not differ significantly in the different directions and resulted in an average shrinkage of respectively 2.7% and 12.6% of the original dimensions. The alterations of the dimensions by section cutting and mounting is not a process of shrinkage, but actually a deformation caused by pressure on the tissue during sectioning. Generally the dimension decreases in the cutting direction and increases in the direction perpendicular to it. In the calculation of the total shrinkage these alterations can be neglected, since the changes, although not consistent are small. It follows that in morphometric studies a total shrinkage of about 15% of the original dimensions has to be taken into consideration.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Three Cambridge Center, Cambridge, Massachusetts 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In a group of 367 women treated for invasive carcinoma of the cervix tumor recurrence was discovered at an asymptomatic stage in 16 (23%) patients. The tumor recurrence was localized to the pelvis in 29 (41%) cases, in the vaginal wall in 3 (4%) cases, and 39 (55%) patients had distant metastases (with or without recurrent tumor in the pelvis). Curative treatment (surgery, n = 2; radiotherapy, n = 8) was applied in 5/29 (17%) patients whose recurrent disease was confined to the pelvis, in all 3 patients with vaginal recurrence and in 2/39 (5%) of the patients with distant metastases. Permanent remission (follow-up 〉 36 months) was observed in 2 patients with vaginal recurrence and in one with central recurrence. Temporary complete remission (mean 22 months, range 12–30 months) was observed in 3 patients (2 with central recurrence and one with vaginal recurrence). In 20 (69%) of the patients with central or locoregional recurrence, the primary treatment had been so radical (including adjuvant postoperative or full radiotherapy) that surgical treatment or radiotherapy of the recurrence was not considered possible or worthwhile; moreover, 4 of the patients were older than 80 years of age. In retrospect, exenterative treatment could have been considered in 14 patients (〈 70 years) and based on 50% operability, could have led to a cure in 2 to 4 patients with tumor recurrence in the pelvis without distant metastases. Chemotherapy was applied to 10 patients, one of whom went into complete remission of lung metastases (follow-up 108 months).
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  • 4
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The efficacy and toxicity of a combination of carboplatin and cyclophosphamide (CC) were studied in a group of 76 patients with advanced ovarian cancer. Progression-free (PFS) and overall survival were compared with a historical group of 65 patients treated with CAP-5 (cyclophosphamide, adriamycin, cisplatin). Subjective toxicity was compared by the measurement of TWiST, the Time Without Symptoms of Disease or Treatment. Of 75 evaluable patients treated with CC, 18 (24%) had a pathologically complete remission (pCR), and 31 (41%) a partial remission (PR). CC led to leukopenia grade III in 38% and grade IV in 3% of 421 treatment cycles. Thrombocytopenia grade III was seen after 7% and grade IV after 2% of cycles. Treatment delay occurred in 11.5% and dose reduction in 21% of cycles. Nephro- or neurotoxicity did not occur. After a median follow-up of 18 months, the median PFS was 24 months and the overall survival was 25 months. Median duration of TWiST was 22 versus 10 months after CAP-5 (P 〈 0.01). Compared with historical controls, treatment with CC is equivalent to CAP-5. It is free of nephro- and neurotoxicity, but is more myelosuppressive. Quality of life, measured by TWiST, is significantly better during CC. As a consequence of its equivalent efficacy, but lower subjective toxicity, carboplatin should replace cisplatin in treating patients with advanced ovarian cancer.
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  • 5
    Electronic Resource
    Electronic Resource
    Suite 500, 5th Floor, 238 Main Street, Cambridge, Massachusetts, 02142, USA : Blackwell Science Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Mature cystic ovarian teratoma with malignant transformation to squamous cell carcinoma was diagnosed in four patients. Squamous cell carcinoma (SCC) antigen serum levels were elevated at diagnosis and during progression of the disease, but normal in complete remission. Elevated serum SCC antigen levels were also found in four out of 19 patients with mature cystic teratoma of the ovary. Cystic fluid from mature cystic teratoma could contain very high levels of the SCC antigen (〉 1000 µg l−1) without any sign of malignant transformation.
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  • 6
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Fifty-three patients with histologically proven ovarian cancer were treated with intraperitoneally administered cisplatin or human recombinant interferon-alpha through a totally implanted peritoneal access port. A total of 281 treatment courses were given. No complications related to surgical implantation of the port were seen. Infectious complications, intra-abdominal problems or subcutaneous drug extravasation did not occur. In two patients the number of treatment courses was limited due to inflow obstruction. A totally implanted peritoneal access port proves to be a reliable route for the intraperitoneal treatment of patients with ovarian cancer. The strict aseptic technique we used contributes to its safety by preventing intra-abdominal infections.
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