Results of chemotherapy for pulmonary metastases of carcinoma of the cervix in patients after primary surgical and radiotherapeutic management.

The purpose of this study was to evaluate the results of chemotherapy of pulmonary metastases from invasive carcinoma of the cervix, which were detected after a disease-free period after initial treatment with surgery or radiotherapy. Fifty patients with radiologically proven pulmonary metastases were treated with chemotherapy. All patients received a platinum-5-fluorouracil (PF) program: cisplatin 75 mg/m(2) and 5-fluorouracil 800 mg/m(2) every 4 weeks. The overall 1- and 3-year survival after PF chemotherapy was 62% and 17.6%, respectively. The progression-free survival at 1 and 3 years was 36.7% and 14.3%, respectively. There were 6 (12%) complete responses and 17 (34%) partial responses. Hematologic tolerance was acceptable. Third degree and fourth degree leukopenia was diagnosed in four (8%) and six (12%) patients, respectively. Three individuals had third degree thrombocytopenia. In the multivariate analysis, the following prognostic factors were associated with poor survival: time to recurrence after primary treatment (P= 0.002), number of lung metastases (P= 0.016), and progression during chemotherapy (P= 0.001). We conclude that PF regimen is a safe and reasonably effective chemotherapy in the management of patients with pulmonary metastases after primary treatment for invasive carcinoma of the cervix who do not qualify for surgical metastasectomy.

The evaluation of intra- and postoperative complications related to debulking surgery with bowel resection in patients with FIGO stage III-IV ovarian cancer.

The surgical treatment of advanced ovarian cancer is based on the maximal debulking with widening the operation range to the infiltrated organs. The aims are as follows: (1) the assessment of the quantity and quality of intra- and postoperative complications in patients with advanced ovarian cancer in which partial bowel resection was performed and (2) the evaluation of intra- and postoperative complications related to surgery with bowel resection and anastomosis, compared to Hartmann's procedure. The analysis of debulking procedures with intestinal resection and postoperative period in 39 ovarian cancer patients, FIGO stage III-IV, was performed. During 39 operations, the most frequent type of resection was the sigmoidectomy or proctosigmoidectomy (29 patients). In the remaining patients, left- and right-side hemicolectomy or partial enterectomy was done. Twenty-four anastomosis and 15 Hartmann's procedures were performed. There were no differences between surgery with anastomosis and Hartmann's procedure in aspect of quantity of complications, blood loss, and the time of surgery. There were no statistically significant differences in overall survival and progression-free survival in both groups. We conclude that the percentage of complications related to debulking surgery with intestinal resection in advanced ovarian cancer patients might be accepted. The quantity of complications related to surgery with anastomosis and to Hartmann's procedure is similar. If possible, the surgery with anastomosis should be performed.

Comparison of the results of surgical treatment using laparoscopy and laparotomy in patients with endometrial cancer.

The objective of the current study was to compare the results of surgical treatment in endometrial cancer with the use of laparoscopy and the traditional approach of laparotomy. Our goal was to evaluate and compare the morbidity, recurrence rate, and disease-free survival in both groups. This article is a retrospective study. A chart review of 45 patients treated by laparoscopy between 1994 and 2002 and 136 patients treated by laparotomy between 2001 and 2002 was performed. Disease-free survival in both groups was evaluated with the Kaplan-Meier method and was compared using the log-rank test. The rate of recidive was 6% in the laparoscopy group and 13% in the laparotomy group. There was no statistically significant difference in disease-free survival and recidive rate between the laparoscopy and laparotomy groups. Laparoscopic management in endometrial cancer does not worsen the prognosis, and the disease-free survival is similar to that resulting from the traditional approach. The benefits of minimal invasive surgery are quicker postoperative recovery, shorter hospital stay, and no wound complications.

Analysis of the treatment of ovarian cancer patients with neo-adjuvant chemotherapy--preliminary results.

INTRODUCTION: Primary surgery and adjuvant chemotherapy is the standard treatment in ovarian cancer patients. Neo-adjuvant chemotherapy is one of the treatment modes in patients with a poor general condition or advanced disease, not adjustable for primary surgery. The purpose of this study was to evaluate if the efficacy of this new option of therapy is comparable to the standard method. MATERIALS AND METHODS: 319 ovarian cancer patients, FIGO Stage III and IV, have been analyzed. Within this group, 50 women were treated with neo-adjuvant chemotherapy. 18 patients were operated after three cycles of neo-adjuvant chemotherapy, and 32 patients--after six cycles. Results of treatment were evaluated, including disease-free survival, and number of complications. Factors that may influence the treatment results were also analyzed. RESULTS: Median disease-free survival in the group treated with adjuvant chemotherapy (group 3), and operated on after three cycles of neo-adjuvant chemotherapy (group 1), were 19 and 20 months, respectively. For the group operated on after six cycles of neo-adjuvant chemotherapy (group 2), median disease-free survival was 15 months (p = 0.27). The following factors have been found to influence treatment results: optimal cytoreduction and tumor grading. There was no difference in complication rates among the three analyzed groups.

[Clinical usefulness of color doppler flow examination during treatment of gestational trophoblastic disease]. / Ocena przydatnosci klinicznej badan przeplywów naczyniowych z uzyciem kolorowego Dopplera u chorych leczonych z powodu ciazowej choroby trofoblastycznej.

Neovascularisation is the integral part of tumor development. Presence and type of pathological vascularisation can be used in therapy monitoring and follow up. The value of beta HCG and pulsatility index (PI) and resistance index (RI) in 14 women treated for nonmetastatic persistent trophoblastic disease (NMTD) were been compared. There was statistical, significant correlation between dropped BHCG level and increased value of RI. No correlation between BHCG blood concentration and values of PI was observed. In summary it should be stated that color Doppler ultrasonography is useful method in monitoring patients with NMTD.

[Antibiotic-resistant cystitis in the course of urinary bladder calculi after vesicoureteral reflux operation many years ago]. / Oporne na leczenie przeciwbakteryjne zapalenie pecherza moczowego w przebiegu kamicy u osoby po operacji odplywu pecherzowo-moczowodowego przed laty.

This is the introduction of chronic cystitis in course of urinary bladder calculi, 12 years after vesicoureteral reflux operation. The nucleus of the calculus (3 x 3 x 4 cm) were unresorbed dexon sutures left after the surgical treatment. Inaccuracy of radiological and ultrasonography examination delayed the settlement of the diagnosis about 18 months, and patient was caused of many months antibacterial therapy. After removal the calculus from the urinary bladder, dysuric disorders abated quickly and than after 8 weeks antibacterial therapy pathological changes in urine analysis disappeared, urine culture was sterile.