Subject(s)
Medical Oncology , Neoplasm Staging , Ovarian Neoplasms/surgery , Female , Humans , Ovarian Neoplasms/mortality , Treatment OutcomeSubject(s)
Ovarian Neoplasms/mortality , Teratoma/mortality , Adolescent , Adult , Cyclophosphamide/administration & dosage , Dactinomycin/administration & dosage , Drug Therapy, Combination , Female , Humans , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/surgery , Teratoma/drug therapy , Teratoma/surgery , Vincristine/administration & dosageSubject(s)
Genital Neoplasms, Female/pathology , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Carcinoma/pathology , Carcinoma/surgery , Fallopian Tube Neoplasms/pathology , Fallopian Tube Neoplasms/surgery , Female , Genital Neoplasms, Female/surgery , Humans , Laparotomy , Neoplasm Recurrence, Local/pathology , Ovarian Neoplasms/pathology , Ovarian Neoplasms/surgery , Uterine Neoplasms/pathology , Uterine Neoplasms/surgerySubject(s)
Adenocarcinoma/surgery , Carcinoma, Squamous Cell/surgery , Ovary/physiology , Uterine Cervical Neoplasms/surgery , Adenocarcinoma/radiotherapy , Adolescent , Adult , Carcinoma, Squamous Cell/radiotherapy , Estrogens/physiology , Estrogens/radiation effects , Female , Follicle Stimulating Hormone/physiology , Follicle Stimulating Hormone/radiation effects , Humans , Hysterectomy , Luteinizing Hormone/physiology , Luteinizing Hormone/radiation effects , Methods , Ovary/radiation effects , Ovary/surgery , Postoperative Complications , Radiotherapy Dosage , Uterine Cervical Neoplasms/radiotherapyABSTRACT
Thirty-nine patients with multifocal carcinoma in situ of the vulva were managed with en bloc removal of the involved skin and a split-thickness skin graft to the surgical defect. The characteristic presentations of this clinical entity are reported and options for the therapy are discussed. Thirty-nine percent of the patients developed a recurrence, but none of the recurrences was within the donated skin graft. No reports of dyspareunia or seriously altered sexual function were noted. The details of the surgical approach ae outlined and modifications of the original procedure are described.
Subject(s)
Carcinoma in Situ/surgery , Vulvar Neoplasms/surgery , Adult , Female , Humans , Methods , Middle Aged , Neoplasm Recurrence, Local , Skin Transplantation , Transplantation, AutologousABSTRACT
Immunotherapy with nonspecific immunopotentiators such as Corynebacterium parvum is under study in several areas of gynecologic oncology. The efficacy of this new modality awaits the results of carefully done clinical trials designed to measure an improved effect on survival when this and similar agents are added to conventional therapy. This report deals with an attempt to demonstrate enhancement of the cell-mediated immune response in a small number of patients with advanced ovarian (18 patients) and cervical (12 patients) cancer who were treated with intravenous C. parvum in addition to either chemotherapy (Alkeran) or pelvic radiotherapy. Monitoring of the immune response was accomplished by skin testing, T-lymphocyte rosettes, B-lymphocyte rosettes, simulation of lymphocytes with mitogens (PHA and Con-A) and total lymphocyte counts. No distinct improvement in these parameters could be demonstrated as a result of immunotherapy with C. parvum. These results and the value of immune monitoring as currently performed are discussed.
Subject(s)
Immunity, Cellular , Immunotherapy , Monitoring, Physiologic/methods , Ovarian Neoplasms/therapy , Propionibacterium acnes/immunology , Uterine Cervical Neoplasms/therapy , B-Lymphocytes/immunology , Female , Humans , Leukocyte Count , Lymphocyte Activation , Ovarian Neoplasms/immunology , Rosette Formation , Skin Tests , T-Lymphocytes/immunology , Uterine Cervical Neoplasms/immunologyABSTRACT
Early invasive squamous cell carcinoma of the vulva has emerged as a controversial issue in recent literature. Reports illustrating metastatic disease in the inguinal lymph nodes have conflicted with other reports suggesting local treatment only. The morbidity produced by radical vulvectomy to both body image and sexual function make this issue worthy of serious consideration. This report deals with an alternate approach to this disease entity which attempts to preserve vulvar tissue without sacrificing curability where possible metastatic disease exists. The concept is proposed of utilizing the superficial inguinal nodes as sentinel nodes in the treatment planning. The results of 20 patients treated in this manner are presented.
